CAJ | 학술논문

目的：应用实时三维斑点追踪成像(RT-3DSTI)测量心肌梗死收缩期左心室心肌整体峰值纵向应变(GPSL)、整体纵向应变(GLS)、整体圆周应变(GCS)、整体面积应变(GAS)及整体径向应变(GRS)，探讨其评价左心室整体收缩功能的可行性和重复性。方法83例研究对象，包括心肌梗死患者38例，健康对照者45例；采用RT-3DSTI测量收缩期左心室GPSL、GLS、GCS、GAS、GRS；分析心肌梗死组RT-3DSTI特征，并探讨其与实时三维超声(RT-3DE)测量射血分数的相关性；随机选取20例心肌梗死患者，用Bland-Altman法研究RT-3DSTI在观察组内和观察组间的重复性。结果⑴心肌梗死组收缩期左心室GPSL、GLS、GCS、GAS、GRS显著低于对照组，差异有统计学意义(P<0.01)；⑵ROC曲线显示GPSL、GLS和GAS能反映心肌梗死组整体应变的变化；⑶GPSL、GLS、GCS、GAS及GRS与RT-3DE射血分数有良好的相关性；⑷Bland-Altman法显示心肌梗死患者RT-3DSTI测量在观察组内和观察组间均有良好的一致性。结论 RT-3DSTI可简便快速评价心肌梗死左心室整体收缩功能，其测量左心室整体功能不依赖左心室负荷变化的影响，可能是一种评价左心室整体收缩功能有前景的技术。
목적：응용실시삼유반점추종성상(RT-3DSTI)측량심기경사수축기좌심실심기정체봉치종향응변(GPSL)、정체종향응변(GLS)、정체원주응변(GCS)、정체면적응변(GAS)급정체경향응변(GRS)，탐토기평개좌심실정체수축공능적가행성화중복성。방법83례연구대상，포괄심기경사환자38례，건강대조자45례；채용RT-3DSTI측량수축기좌심실GPSL、GLS、GCS、GAS、GRS；분석심기경사조RT-3DSTI특정，병탐토기여실시삼유초성(RT-3DE)측량사혈분수적상관성；수궤선취20례심기경사환자，용Bland-Altman법연구RT-3DSTI재관찰조내화관찰조간적중복성。결과⑴심기경사조수축기좌심실GPSL、GLS、GCS、GAS、GRS현저저우대조조，차이유통계학의의(P<0.01)；⑵ROC곡선현시GPSL、GLS화GAS능반영심기경사조정체응변적변화；⑶GPSL、GLS、GCS、GAS급GRS여RT-3DE사혈분수유량호적상관성；⑷Bland-Altman법현시심기경사환자RT-3DSTI측량재관찰조내화관찰조간균유량호적일치성。결론 RT-3DSTI가간편쾌속평개심기경사좌심실정체수축공능，기측량좌심실정체공능불의뢰좌심실부하변화적영향，가능시일충평개좌심실정체수축공능유전경적기술。
Objective The paper is aimed at exploring and evaluating left ventricle systolic function’s practical meaning by using RT-3DSTI to measure speckle tracking’s GPSL, GLS, GCS, GAS and GRS. Methods With 83 patients cases including 38 patients diagnosed with myocardial infarction and 45 patients of healthy control group, the paper takes way of RT-3DSTI to measure the systolic left ventricular GPSL, GLS, GCS, GAS, GRS, analyses the characteristics of myocardial infarction group RT-3DSTI, explores its relationship with the real-time three-dimensional echocardiography(RT-3DE) measurement of ejection fraction. Besides, the Bland-Altman method is used to research myocardial infarction group RT-3DSTI in the observation group and the observation group and the consistency. Results ⑴GPSL, GLS, GCS, GAS, GRS’s measurement of myocardial infarction group systolic left ventricular is significantly lower than the control group’s. The difference was statistically significant(P<0.01). ⑵The ROC curve display, GPSL, GLS and GAS can display the change of left myocardial infarction overall strain accurately. ⑶There was a good correlation between GPSL, GLS, GCS, GAS and GRS and RT-3DE ejection fraction. ⑷Bland-Altman method shows that the consistency of RT-3DSTI in patients with acute myocardial infarction in the observation group measurement and observation group has a good consistency. Conclusions RT-3DSTI can simply and quickly evaluate the systolic global left ventricular myocardial function which does not depend on left ventricular load change, and this method may be an overall assessment of left ventricular systolic function promising technology.