天津医药

天津医药 ›› 2014, Vol. 42 ›› Issue (12): 1229-1233.doi: 10.3969/j.issn.0253-9896.2014.12.022

• 应用研究 • 上一篇    下一篇

实时三维超声及二维斑点追踪技术对拟诊冠心病患者局部室壁运动的评价

田园1,王伟1,周长钰2   

  1. 1. 天津医科大学第二医院
    2. 天津医科大学第二医院心脏科
  • 收稿日期:2014-05-04 修回日期:2014-08-07 出版日期:2014-12-15 发布日期:2014-12-15
  • 通讯作者: 周长钰 E-mail:zhouchangyu_tj@126.com

Evaluation of the regional wall motion in patients with suspected coronary artery disease by real-time three-dimensional echocardiography and two-dimensional speckle tracking imaging

yuan tian,WANG Wei ,ZHOU Changyu   

  1. Department of Cardiology, the Second Hospital of Tianjin Medical University, Tianjin 300211, China
  • Received:2014-05-04 Revised:2014-08-07 Published:2014-12-15 Online:2014-12-15
  • Contact: ZHOU Changyu E-mail:zhouchangyu_tj@126.com

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摘要：

【摘要】 目的 探讨实时三维超声（RT-3DE）及二维斑点追踪成像（2D-STI）技术检测拟诊冠心病患者局部室壁运动功能的临床应用价值。 方法 选取临床拟诊为冠心病、二维超声示室壁运动正常的住院患者 143 例， 根据冠脉造影左冠状动脉主干（LM）和（或）左前降支（LAD）和（或）左回旋支（LCX）病变结果分为狭窄≥75%组（A 组）73 例和狭窄＜ 75%组（B 组）70 例。 应用 RT-3DE 及 2D-STI 分别检测并比较 2 组患者左室节段射血分数（sEF）和收缩期纵向峰值应变（SL）， 利用 ROC 曲线比较 2 种技术诊断冠心病的曲线下面积。 结果 （1）A 组病变冠脉所支配室壁的 sEF 及 SL均较 B 组减小（P＜ 0.05）；（2）节段平均 sEF 与节段平均 SL呈正相关（r=0.689， P＜ 0.05）；（3）两项指标均显示异常的左冠供血各节段 sEF 对诊断供血冠脉狭窄≥75%的曲线下面积大于 S（ L 最大曲线下面积分别为 0.922 和 0.874）。 结论 RT-3DE 及 2D-STI 均可评估冠心病患者的心肌局部运动状况， 进而推测冠脉病变程度， 但 RT-3DE 指标可能更优于 2D-STI。

关键词: 实时三维超声, 二维斑点追踪技术, 冠心病, 局部室壁运动

Abstract:

[Abstract] Objective To evaluate the clinical value of the regional wall motion in patients with suspected coronary artery disease by real-time three-dimensional echocardiography (RT-3DE) and two-dimensional speckle tracking imaging (2D-STI). Methods A total of 143 hospitaized patients with suspected coronary artery disease and normal wall motion de? tected by two-dimensional echocardiography (2DE) were enrolled and devided into group A (coronary stenosis ≥75%) 73 cases and group B (coronary stenosis < 75%) that include 70 cases according to coronary angiography results. Left ventricu? lar segmental ejection fraction (sEF) was measured by RT-3DE and peak systolic longitudial strain (SL) was measured by 2DSTI. ROC curves of the two measurements were generated and compared. Differences in sEF and SL between group A and group B were respectively analyzed. Results （1） Both sEF of RT-3DE and SL of 2D-STI in group A were significantly low? er than those in group B (P＜ 0.05);（2） sEF was positively correlated with SL(r=0.689， P＜ 0.05);（3） Compared with SL, sEF had larger area under ROC curve in some segments of left ventricle where both parameters are abnormal for the diagnosis of the coronary stenosis ≥75% (0.922 vs 0.874). Conclusion Regional wall motion of left ventricular can be measured by both RT-3DE and 2D-STI which can be both used to estimate the extend of stenosis of coronary artery. And RT-3DE is su? perior over 2D-STI.

Key words: real-time three dimensional echocardiography, two-dimensional speckle tracking imaging, coronary heart disease, regional wall motion