CAJ | 학술논문

目的应用三维超声斑点追踪技术(three-dimensional speckle tracking imaging,3D-STI)评价不同冠状动脉狭窄程度对应的心肌节段的径向收缩期峰值应变(the systolic peak radial strain,RS)和径向应变达峰时间(the time to systolic peak radial strain,TRS).方法拟诊冠心病患者87例,均接受冠状动脉造影检查.所有心肌节段按冠状动脉狭窄情况分为5组:0级组,冠状动脉无狭窄;1级组,冠状动脉狭窄≤25％;2级组,冠状动脉狭窄＞25％～≤50％;3级组,冠状动脉狭窄＞50％～≤75％;4级组,冠状动脉狭窄＞75％.运用3D-STI自动测量左心室壁16个节段的RS和TRS,采用心率对所有时间值进行校正.结果 0级组、1级组和2级组各节段RS差异无统计学意义(P＞0.05);3级组和4级组较0级组、1级组和2级组病变冠状动脉相对应的部分节段RS减低;4级组较3级组RS减低,差异有统计学意义(P＜0.05).0级组和1级组各节段TRS差异无统计学意义(P＞0.05);2级组、3级组和4级组病变冠状动脉相对应的部分节段TRS较0级组和1级组延迟;3级组和4级组较2级组TRS延迟;与3级组比较,4级TRS相对提前,冠状动脉病变相对应部分节段差异有统计学意义(P＜0.05).结论左心室壁冠状动脉病变相对应节段的RS随冠状动脉狭窄程度的加重而减低,TRS随狭窄程度的加重而延迟.重度冠状动脉狭窄(＞75％)时,病变冠状动脉相对应节段TRS较轻中度冠状动脉狭窄(＞50％～≤75％)组有提前的趋势.3D-STI可以评价不同冠状动脉狭窄程度的局部心肌收缩功能改变.
목적 응용삼유초성반점추종기술(three-dimensional speckle tracking imaging,3D-STI)평개불동관상동맥협착정도대응적심기절단적경향수축기봉치응변(the systolic peak radial strain,RS)화경향응변체봉시간(the time to systolic peak radial strain,TRS).방법 의진관심병환자87례,균접수관상동맥조영검사.소유심기절단안관상동맥협착정황분위5조:0급조,관상동맥무협착;1급조,관상동맥협착≤25％;2급조,관상동맥협착＞25％～≤50％;3급조,관상동맥협착＞50％～≤75％;4급조,관상동맥협착＞75％.운용3D-STI자동측량좌심실벽16개절단적RS화TRS,채용심솔대소유시간치진행교정.결과 0급조、1급조화2급조각절단RS차이무통계학의의(P＞0.05);3급조화4급조교0급조、1급조화2급조병변관상동맥상대응적부분절단RS감저;4급조교3급조RS감저,차이유통계학의의(P＜0.05).0급조화1급조각절단TRS차이무통계학의의(P＞0.05);2급조、3급조화4급조병변관상동맥상대응적부분절단TRS교0급조화1급조연지;3급조화4급조교2급조TRS연지;여3급조비교,4급TRS상대제전,관상동맥병변상대응부분절단차이유통계학의의(P＜0.05).결론 좌심실벽관상동맥병변상대응절단적RS수관상동맥협착정도적가중이감저,TRS수협착정도적가중이연지.중도관상동맥협착(＞75％)시,병변관상동맥상대응절단TRS교경중도관상동맥협착(＞50％～≤75％)조유제전적추세.3D-STI가이평개불동관상동맥협착정도적국부심기수축공능개변.
Objective To assess the alterations of the systolic peak radial strain (RS) and the time to systolic peak radial strain(TRS) in ischemic myocardial segments with different extent of coronary artery stenosis using three-dimensional ultrasound speckle tracking imaging(3D-STI).Methods RS and TRS of 16 left ventricular segments were analyzed by 3D-STI in 87 patients,every left ventricular segment of all patients were divided into 5 groups according to coronary stenosis based on the results of selected coronary angiography:normal,≤25 ％,＞25 ％ - ≤50 ％,＞50 ％ - ≤ 75 ％,＞ 75 ％.All times were corrected by heart rate.Results In the coronary normal group,coronary stenosis extent ≤25％ group and coronary stenosis extent ＞25％ - ≤50％ group,the variance of RS was non-significant( P ＞0.05).Compared with the coronary normal group,coronary stenosis extent ≤25％ group and coronary stenosis extent ＞ 25％ -≤ 50％ group,RS was decreased in groups of coronary stenosis ＞50％ - ≤75％ and ＞75％.Between the coronary normal group and coronary stenosis extent ≤25 ％ group,the variance of TRS was non-significant( P ＞0.05).Compared with coronary normal and coronary stenosis extent ≤25 ％ group,TRS was increased in groups of coronary stenosis ＞25％ - ≤50％,＞50％ - ≤75％,＞75％.Compared with group of coronary stenosis ＞ 50％ -≤ 75％,TRS was shorter in group of coronary stenosis ＞ 75％,some variance was significant( P ＜0.05).Conclusions The RS was decreased along with the coronary stenosis increase,but TRS was increased along with the coronary stenosis increase.There is a tendency that TRS was decreased when the coronary stenosis is more than 75 ％ compared with the coronary stenosis ＞50％ - ≤75 ％ group.3D-STI can access the regional radial systolic function of the ischemic myocardial segment.