天津医科大学学报
天津醫科大學學報
천진의과대학학보
JOURNAL OF TIANJIN MEDICAL UNIVERSITY
2015年
3期
199-202
,共4页
实时三维超声%局部室壁运动%节段射血分数%冠状动脉狭窄
實時三維超聲%跼部室壁運動%節段射血分數%冠狀動脈狹窄
실시삼유초성%국부실벽운동%절단사혈분수%관상동맥협착
real-time three dimensional echocardiography%myocardial segment motion%segmental ejection fraction%coronary arteriostenosis
目的：应用实时三维超声心动图（RT-3DE）检测冠心病患者右冠状动脉供血心肌节段的运动、时间及容积参数改变，探讨对该动脉狭窄程度的判断价值。方法：选取冠状动脉造影（CAG）显示右冠脉病变的患者87例，分为右冠脉狭窄＜75%组（A组）47例；狭窄≥75%组（B组）40例；3支冠脉均未见明显狭窄者68例作为对照组（N组）。所有入选者行RT-3DE检查，记录右冠状动脉供血的心肌节段平均运动幅度（EA）、收缩期心室运动峰值时间（TS）、节段舒张末容积（sEDV）、节段收缩末容积（sESV）并计算左室节段射血分数。对所得部分参数进行ROC曲线分析及判别分析。结果：（1）B组下壁、后间隔基底段、中间段和后壁基底段EA值及下壁、后间隔、后壁基底段sEF值明显小于A及N组（P＜0.05）；A组与N组间无明显差异（P＞0.05）。TS在3组间未见明显差异（P＞0.05）；(2)以右冠脉狭窄程度≥75%为分组变量，以下壁基底段EA、sEF为自变量行判别分析，得右冠脉狭窄≥75%判别函数Y=0.830sEF+0.481EA，判别临界值Y0=0.653，交互检验敏感度82.5%，特异度91.49%，准确率87.36%。结论： RT-3DE可定量测定节段心肌的运动幅度和收缩功能；选择适宜参数建立的判别函数可推断相应供血冠脉的病变程度。
目的：應用實時三維超聲心動圖（RT-3DE）檢測冠心病患者右冠狀動脈供血心肌節段的運動、時間及容積參數改變，探討對該動脈狹窄程度的判斷價值。方法：選取冠狀動脈造影（CAG）顯示右冠脈病變的患者87例，分為右冠脈狹窄＜75%組（A組）47例；狹窄≥75%組（B組）40例；3支冠脈均未見明顯狹窄者68例作為對照組（N組）。所有入選者行RT-3DE檢查，記錄右冠狀動脈供血的心肌節段平均運動幅度（EA）、收縮期心室運動峰值時間（TS）、節段舒張末容積（sEDV）、節段收縮末容積（sESV）併計算左室節段射血分數。對所得部分參數進行ROC麯線分析及判彆分析。結果：（1）B組下壁、後間隔基底段、中間段和後壁基底段EA值及下壁、後間隔、後壁基底段sEF值明顯小于A及N組（P＜0.05）；A組與N組間無明顯差異（P＞0.05）。TS在3組間未見明顯差異（P＞0.05）；(2)以右冠脈狹窄程度≥75%為分組變量，以下壁基底段EA、sEF為自變量行判彆分析，得右冠脈狹窄≥75%判彆函數Y=0.830sEF+0.481EA，判彆臨界值Y0=0.653，交互檢驗敏感度82.5%，特異度91.49%，準確率87.36%。結論： RT-3DE可定量測定節段心肌的運動幅度和收縮功能；選擇適宜參數建立的判彆函數可推斷相應供血冠脈的病變程度。
목적：응용실시삼유초성심동도（RT-3DE）검측관심병환자우관상동맥공혈심기절단적운동、시간급용적삼수개변，탐토대해동맥협착정도적판단개치。방법：선취관상동맥조영（CAG）현시우관맥병변적환자87례，분위우관맥협착＜75%조（A조）47례；협착≥75%조（B조）40례；3지관맥균미견명현협착자68례작위대조조（N조）。소유입선자행RT-3DE검사，기록우관상동맥공혈적심기절단평균운동폭도（EA）、수축기심실운동봉치시간（TS）、절단서장말용적（sEDV）、절단수축말용적（sESV）병계산좌실절단사혈분수。대소득부분삼수진행ROC곡선분석급판별분석。결과：（1）B조하벽、후간격기저단、중간단화후벽기저단EA치급하벽、후간격、후벽기저단sEF치명현소우A급N조（P＜0.05）；A조여N조간무명현차이（P＞0.05）。TS재3조간미견명현차이（P＞0.05）；(2)이우관맥협착정도≥75%위분조변량，이하벽기저단EA、sEF위자변량행판별분석，득우관맥협착≥75%판별함수Y=0.830sEF+0.481EA，판별림계치Y0=0.653，교호검험민감도82.5%，특이도91.49%，준학솔87.36%。결론： RT-3DE가정량측정절단심기적운동폭도화수축공능；선택괄의삼수건립적판별함수가추단상응공혈관맥적병변정도。
Objective:To detect myocardial segment motion,time and volume parameters of right coronary artery in patients with coronary heart disease by three-dimensional ultrasound (RT-3DE) . Methods:Eighty-seven patients with unstable angina were diagnosed with right coronary stenosis by coronary angiograph. According to the conditions of coronary arteriostenosis, patients were divided into group A (47 patients, coronary stenosis<75%) and group B (40 patients, coronary stenosis ≥75%). Coronary angiography showed no marked stenosis in 68 patients of control group. All candidates underwent RT-3DE to get left ventricular 17 segments range of motion (EA),the peak systolic ventricular momotion time(TS),segmental end diastolic volume (sEDV),segmental end systolic volume (sESV), and calculated left ventricular segmental ejection fraction. Some parameters were obtained by ROC curve analysis and discriminant analysis. Results: (1) Compared with group A and group N, the EA of inferior, posterior septal basal segment, middle segment and posterior basal segment and the sEF of inferior, posterior septal and posterior basal segmentin of group B were significantly lower (P<0.05). However, no significant difference between group A and group N was found in EA and sEF. And no significant difference in TS was found among three groups. (2). sEF and EA of inferior basal segment were taken as independent variables to establish discriminant function Y=0.830sEF+0.481EA (P<0.001). The critical value was Y0=0.653, with total accuracy rate of 87.36%, a sensitivity of 82.5%and a specificity of 91.4%. Conclusion:RT-3DE can accurately assess segmental myocardial range of motion and systolic function, and choosing the appropriate parameters to establish the discriminant function may be useful to predict the pathological change of coronary arteriostenosis .
