STE在STEMI患者择期PCI后左心功能判断中的临床应用价值

Clinical Value of STE in the Assessment of Left Ventricular Function in Patients with STEMI after Selective PCI

【目的】探讨斑点追踪超声心动图(STE)对急性ST段抬高型心肌梗死(STEMI)患者行择期经皮冠状动脉介入治疗(PCI)后左室心功能的评估.【方法】选取2016年1月至2017年4月本院收治的92例STEMI患者(观察组),选择同期因胸痛行冠脉CTA检查者(排除冠状动脉病变)60例作为对照组,两组均给予STE检查.记录比较两组整体纵向应变(GLS)、整体径向应变(GRS)、整体圆周应变(GCS)和整体面积应变(GAS).并比较两组左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)及左室射血分数(LVEF).【结果】观察组PCI术前及术后12个月GLS、GRS、GCS、GAS均明显低于对照组,且观察组PCI术后12个月GLS、GRS、GCS、GAS明显高于PCI术前,差异均有统计学意义(P<0.05).观察组PCI术前及术后12个月LVEDV、LVESV均高于对照组,LVEF低于对照组,差异均有统计学意义(P<0.05);观察组PCI术后12个月LVEDV、LVESV低于PCI术前,LVEF高于PCI术前,差异均有统计学意义(P<0.05).Pearson相关分析显示,GLS、GRS、GCS、GAS与LVEF均呈显著正相关性(r分别为0.405、0.413、0.387、0.422,均P<0.05).【结论】斑点追踪超声心动技术可较好的定量评价STEMI患者择期PCI术后心功能情况,值得临床推广应用.

【Objective】To evaluate speckle tracking echocardiography(STE)in judgement of the left ventricular function in patients with acute ST-segment elevation myocardial infarction(STEMI)after selective percutaneous coronary intervention(PCI).【Methods】From January 2016 to April 2017,92 STEMI patients(observation group)were selected from our hospital,and 60 patients(excluding coronary artery lesions)who had coronary CTA examination due to chest pain at the same time were selected as the control group.Both groups were given stem examination.The global longitudinal strain(GLS),global radial strain(GRS),global circumferential strain(GCS)and global area strain(GAS)were recorded and compared between the two groups.Left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV)and left ventricular ejection fraction(LVEF)were compared between the two groups.【Results】The GLS,GRS,GCS and gas of the observation group were significantly lower than those of the control group before and 12 months after PCI,and the GLS,GRS,GCS and gas of the observation group were significantly higher than those of the PCI group(P<0.05).LVEDV and LVESV in the observation group were higher than those in the control group before and 12 months after PCI,and LVEF was lower than that in the control group,with statistical significance(P<0.05);LVEDV and LVESV in the observation group were lower than that before PCI,and LVEF was higher than that before PCI,with statistical significance(P<0.05).Pearson correlation analysis showed that GLS,GRS,GCS,GAS and LVEF were significantly positively correlated(r=0.405,0.413,0.387,0.422,respectively,P<0.05).【Conclusion】Spot tracking echocardiography(STE)can be used to evaluate the cardiac function of STEMI patients after PCI,which is worthy of clinical application.