Tei指数与二维斑点追踪成像技术评价左前降支病变患者左心功能变化的价值

Values of Tei index and two-dimensional spot tracking imaging in assessment of left heart function in patients with left anterior descending branch lesions

目的 探讨应用Tei指数与二维斑点追踪成像技术（2D-STI）评价左前降支轻中度狭窄病变患者左心功能变化的临床价值。方法 30例冠状动脉左前降支轻中度狭窄（50~70%）患者作为病例组（A组）,42例冠脉正常患者作为对照组（B组）,均行常规二维超声心动图检查。应用组织多普勒（TDI）测量心室等容收缩时间（ICT）、等容舒张时间（IRT）、射血时间（ET）,计算Tei指数;留取心尖左室长轴观、四腔观以及二腔观的二维灰阶动态图像,应用STI软件分析左室长轴18个节段收缩期纵向应变。结果 2组二维超声测值比较无显著差异（P〉0.05）;A组IRT＋ICT增加,ET缩短,Tei指数减低,与B组比较差异有统计学意义（P〈0.05）;与B组相比,A组收缩期纵向应变均减低,前壁中间段、心尖段及前间隔中间段、心尖段、后间隔中间段差异有统计学意义（P〈0.05）,左心室其余各节段差异无统计学意义（P〉0.05）。结论 应用Tei指数与2D-STI技术可以早期、定量评价左前降支轻中度狭窄患者左心整体与局部功能的改变。

Objective To investigate the clinical value of Tel index and two-dimensional speckle tracking imaging （2D-STI） in evaluating left heart function change in patients with mild to moderate stenosis in left anterior descending branch. Methods A total of 30 patients with mild to moderate stenosis in left anterior descending branch were selected as observation group （ group A）, while 42 patients without any coronary lesion were enrolled as control group （group B）. Both groups were given conventional two-dimensional echocardiography by using tissue Doppler （TDI） to measure ventrieular volume contraction time （ICT）, isovolumetric relaxation time （IRT） and ejection time （ET） for calculation of Tel index. Additionally, the apical left ventricular long- axis view as well as two dimensional dynamic image gray - scale images of four chambers and two chambers were separately utilized to analyze 18 segmental systolic longitudinal strains of left ventricle. Results No significant difference was observed in two-dimensional ultrasonic measurement between two groups （P 〉 0.05 ）. Compared with group B, IRT ＋ ICT increased, ET shortened and Tel index declined in group A （P 〈 0.05）. Compared with group B, group A longitudinal systolic strain reduced in group A, and there were significant differences in anterior wall middle section, apex, apex section, and interval before the middle paragraphs interval after the middle period （P 〈 0. 05 ）, but there was no significant difference in left ventricular segmental （P 〉 0.05）. Conclusion Tei index and 2D-STI technology may benefit for early quantitative evaluation of the whole and local function change of left heart in patients with mild to moderate stenosis in left anterior descending branch.