超声斑点追踪成像对冠状动脉旁路移植术患者左心室功能的评价研究分析

Role of ultrasonic speckle tracking imaging in assessing the left ventricular function in patients undergoing coronary artery bypass grafting

目的应用超声斑点追踪成像(STI)技术对接受冠状动脉旁路移植术(CABG)患者治疗前后的左心室功能进行评价研究。方法选取单纯接受CABG患者30例作为手术组,健康志愿者30例作为对照组,均行常规经胸超声检查,测量室间隔厚度、左心室前后径、LVEF;对照组体检时,手术组行CABG术前,术后4~7d和1个月均应用STI技术监测左心室功能变化,并进行对比分析。结果手术组术前、术后4~7d和术后1个月左心室的整体应变值较对照组减低[(14.8±3.2)%,(14.4±3.4)%,(16.2±3.0)%vs(17.6±4.1)%,P<0.05];且术后1个月各节段整体应变值较术前升高(P<0.05)。手术组术后1个月不同切面左心室三腔观总体纵向应变值[(19.4±3.2)%vs(17.4±3.2)%]、左心室四腔观总体纵向应变值[(19.9±1.9)%vs(18.5±2.4)%]、左心室二腔观总体纵向应变值[(18.4±2.6)%vs(16.4±3.1)%]和左心室平均总体纵向应变值[(19.3±3.2)%vs(17.4±4.0)%]较手术前明显升高,差异有统计学意义(P<0.05)。结论 STI能无创及定量地评价CABG患者左心室功能,且具有较高的临床应用价值。

Objective To study the role of ultrasonic speckle tracking imaging （STI） in assessing the left ventricular function in patients undergoing coronary artery bypass grafting （CABG） before and after treatment. Methods Thirty patients who underwent simple CABG served as an operation group and 30 healthy volunteers served as a control group in this study. They underwent conventional transthoracic ultrasonography for the measurement of their interventricular septum thickness,left ventricular anterior and posterior diameters and LVEF. The left ventricular function was minitored by ultrasonic STI in operation group before CABG and on days 4-7 and 1 month after CABG. Results The left ventricular strain value was significantly lower in each period of operation group than in control group on days 4-7 and 1 month ofter operation （14.8± 3.2,14.4±3.4,16.2±3.0 vs 17.6±4.1,P〈0.05） and the strain value of different segments in- creased with the proloned blood supply time of bypass blood vessels and was higher after opera- tion than before operation （P〈0.05）. The GLPS-LAX, GLPS-A4C,GLPS-A2C and GLPS-Avg were significantly higher in operation group 1 month after operation than in preoperative （19.4% ± 3.2% vs 17. 4%±3.2%,19.9%±1.9% vs 18.5%±2. 4%,18. 4%±2. 4% vs 16.4%±3.1%, 19.3%±3.2% vs 17.4%±4.0%,P〈0.05）. Conclusion Ultrasonic STI can noninvasively and quantitatively assess the left ventricular function in patients undergoing CABG and is thus of a rather high clinical application value.