探讨三维超声斑点追踪技术评价不同程度冠状动脉病变患者心肌应变的价值

Evaluation of myocardial strain in patients with different severity of coronary lesions by three-dimensional speckle tracking imaging

目的 探讨三维超声斑点追踪技术对于不同程度冠状动脉病变患者心肌应变的诊断价值.方法 随机选取本院2013年7月至2015年9月期间收治的冠心病患者作为观察组,根据患者病变程度将其分为多支病变组（n=44）和单支病变组（n=39）,同时选取本院同期体检健康者50例将其作为对照组,三组患者均接受三维超声斑点追踪检查（3D-STE）,对患者的技术应变参数进行观察记录,并对技术应变参数同心输出量（CO）、左心室射血分数（LVEF）之间的相关性进行评估.结果 三组患者的超声检查一般参数相比多并无明显差异,但对照组患者的E/A水平明显高于多支病变组和单支病变组患者,差异具有统计学意义（P＜0.05）;且随着患者冠状动脉病变程度的逐渐加重,其GRS、GAS、GCS、GLS水平逐渐降低,其中观察组患者的超声评估技术应变参数均明显低于对照组,差异具有统计学意义（P＜0.05）.结论 三维超声斑点追踪技术可对不同程度冠状动脉病变患者的心肌应变进行可靠、有效评估,可准确对心肌缺血所致局部收缩功能障碍心肌节段进行识别,其临床检查准确性、客观性较高,可作为冠心病患者治疗方案的制定依据及临床疗效评估工具.

Objective To investigate the myocardial strain in patients with different severity of coronary lesions by three-diamensional speckle tracking imaging.Methods Coronary heart disease patients admitted into our hospital from July,2013 to September,2015 were randomly selected as an observation group.The patients were divided into a multi-vessel disease group （n=44） and a single-vessel disease group （n=39）.50 healthy cases were selected from our hospital as a control group.All the three groups received three-dimensional speckle tracking imaging （3D-STE）.The technological strain parameters of the patients were observed and recorded.The correlation the parameters with cardiac output （CO） and left ventricular ejection fraction（LVEF）was evaluated.Results The general parameters of the three groups tested by ultrasound had no significant difference by comparison.But the E/A level of the control group was significantly higher than those of the multi-vessel disease group and the single-vessel disease group,with statistical differences （P〈0.05）.The levels of GRS,GAS,GCS,and GLS decreased gradually with the increase of the severity of coronary lesions.The technological strain parameters of the observation group were significantly lower than those of the control group,with statistical differencea （P〈0.05）.Conclusions Three-dimensional speckle tracking imaging can make reliable and effective evaluation for myocardial strain in patients with different severities of coronary lesions and recognize local contraction disfunction and myocardial segment caused by myocardial ischemia;it has higher accuracy and objectivity in clinical testing and may be used as clinical therapy planning refference and clinical efficacy evaluation tool for coronary heart disease patients.