CAJ | 학술논문

目的应用三维斑点追踪(3D-STI)技术获取冠心病患者左室三维面积应变参数,评价不同冠脉狭窄程度的冠心病患者左室心肌收缩功能及同步性变化,为冠心病患者左室功能及同步性评价提供新依据.方法对94例疑似冠心病患者在冠脉造影术前24 h分别进行常规二维超声心动图及3D-STI检查,用三维应变软件对左室图像进行分析.根据冠脉造影结果将其分为重度狭窄组、中度狭窄组和对照组.测量三组的常规超声参数、整体面积应变(AS)、面积应变不同步指数(ASDI),以及AS达峰时间标准差(AS-SD).结果三组常规超声参数差别无统计学意义(P＞0.05).与中度狭窄组及对照组相比,重度狭窄组AS明显降低,ASDI及AS-SD明显增高(P＜0.001),而中度狭窄组与对照组AS、ASDI及AS-SD差异均无统计学意义(P＞0.05).ROC曲线示以ASDI≥1.90％为截断值检测冠心病患者重度冠脉狭窄诊断价值最高,其灵敏度为84.2％,特异度为94.1％.结论 3D-STI面积应变参数尤其ASDI可作为评价冠心病左室功能及冠脉狭窄程度的有效参考指标.
목적 응용삼유반점추종(3D-STI)기술획취관심병환자좌실삼유면적응변삼수,평개불동관맥협착정도적관심병환자좌실심기수축공능급동보성변화,위관심병환자좌실공능급동보성평개제공신의거.방법 대94례의사관심병환자재관맥조영술전24 h분별진행상규이유초성심동도급3D-STI검사,용삼유응변연건대좌실도상진행분석.근거관맥조영결과장기분위중도협착조、중도협착조화대조조.측량삼조적상규초성삼수、정체면적응변(AS)、면적응변불동보지수(ASDI),이급AS체봉시간표준차(AS-SD).결과 삼조상규초성삼수차별무통계학의의(P＞0.05).여중도협착조급대조조상비,중도협착조AS명현강저,ASDI급AS-SD명현증고(P＜0.001),이중도협착조여대조조AS、ASDI급AS-SD차이균무통계학의의(P＞0.05).ROC곡선시이ASDI≥1.90％위절단치검측관심병환자중도관맥협착진단개치최고,기령민도위84.2％,특이도위94.1％.결론 3D-STI면적응변삼수우기ASDI가작위평개관심병좌실공능급관맥협착정도적유효삼고지표.
Objective To obtain area strain parametersuse of left ventricle in patients with coronary heart disease (CHD) by three-dimensional speckle tracking imaging(3D-STI),evaluate the systolic function and synchronization of left ventricle depending on different degrees of coronary artery stenosis,and then search new evidence for evaluation and diagnosis of the systolic function of left ventricle.Methods 94 patients were recruited diagonosed as CHD were recruited and their 3D-STI dynamic images were stored 24 hours before coronary angiography.All patients were divided into three groups (the severe stenosis group,the moderate stenosis group,and contrast group) according to the results of coronary angiography.Then the conventional echocardiographic parameters,area strain(AS),area strain dyssynchrony index(ASDI),and the standard deviation of the peak time of AS(AS-SD) were measured.Results There were no significant differences among conventional echocardiographic parameters of the three groups.Compared to the moderate stenosis group and the contrast group,the AS,ASDI and AS-SD of the severe stenosis group were significant different (P ＜0.001),however there were no differences between the moderate stenosis group and the contrast group (P ＞0.05).The ROC curve showed that the diagnostic value was the highest to detect severe stenosis when using ASDI≥1.90％ as the cutoff value,with 84.2％ of the sensibility,and 94.1％ of the specificity.Conclusions The area strain parameters of 3D-STI are effective indice as clinical references to evaluate the systolic function of left ventricle and the degree of coronary artery stenosis,in particular,the ASDI is the most effective parameter.