三维斑点追踪技术评价ST段抬高型急性心肌梗死患者介入术后左心室收缩功能变化的价值

Value of 3D-STI in evaluating left ventricular systolic function in patients with ST segment elevation myocardial infarction after percutaneous coronary intervention

目的:探讨三维斑点追踪技术(3D-STI)评价ST段抬高型急性心肌梗死(AMI)患者行经皮冠状动脉介入治疗(PCI)术后左心室收缩功能变化的价值。方法:选取中山市火炬开发区医院及广东药科大学附属第二医院,在2015年8月至2016年8月期间,收治的ST段抬高型AMI患者70例,作为病例组(n=70),同期选择健康体检者70例,作为对照组(n=70)。所有患者均在12个月后行三维心脏彩超及3D-STI;记录并比较两组测量结果。结果:病例组左心室收缩末期容积、左心室舒张末期容积、左心室舒张末期内径高于对照组,差异有统计学意义(F=75.87、57.30、231.84,P<0.01);病例组左心室射血分数低于对照组,差异有统计学意义(F=51.40,P<0.01);病例组整体纵向应变、整体圆周应变、整体径向应变、左心室射血分数均低于对照组,差异具有统计学意义(F=316.01、202.31、68.21、203.58,P<0.01)。结论:ST段抬高型AMI患者行PCI术后12个月的左心室收缩功能仍低于正常人,需继续随访观察。3D-STI对ST段抬高型AMI患者的左心室收缩功能作出较好评估。

Objective： To explore the value of three-dimensional speckle tracking technique（ 3 D-STI）in evaluating left ventricular systolic function in patients with ST segment elevation acute myocardial infarction（ AMI） after PCI. Methods： 70 patients with STEMI and 70 cases healthy people in Zhongshan Torch Development Zone Hospital and The Second Affiliated Hospital of Guangdong Pharmaceutical University from August2015 to August 2016 were selected into the clinical data. All patients were followed by conventional ultrasound and 3 D-STI at 12 months. Two sets of measurement result were recorded. Results： The left ventricular end systolic volume,left ventricular end diastolic volume and left ventricular end diastolic diameter in the case group were higher than those in the control group（ F = 75. 87,57. 30,231. 84,P〈0. 01）. The left ventricular ejection fraction in the case group was lower than that in the control group（ F = 51. 40,P〈0. 01）. The overall longitudinal strain,overall circumferential strain,overall radial strain and left ventricular ejection fraction in the case group were lower than those in the control group（ F = 316. 01,202. 31,68. 21,203. 58,P〈0. 01）.Conclusion： After 12 months of PCI,the left ventricular systolic function in patients with ST segment elevation AMI is still low,who need to continue to follow up. 3 D-STI can be used to estimate the left ventricular systolic function.