中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2015年
23期
2758-2761
,共4页
徐景俊%张丽%卢晓潇%潘宁%崔国利%王薇
徐景俊%張麗%盧曉瀟%潘寧%崔國利%王薇
서경준%장려%로효소%반저%최국리%왕미
血管成形术, 经腔, 经皮冠状动脉%二维斑点追踪成像%心肌梗死%肌钙蛋白T
血管成形術, 經腔, 經皮冠狀動脈%二維斑點追蹤成像%心肌梗死%肌鈣蛋白T
혈관성형술, 경강, 경피관상동맥%이유반점추종성상%심기경사%기개단백T
Angioplasty,transluminal,percutaneous coronary%Two -dimensional speckle tracking imaging%Myocardial infarction%Troponin T
目的:采用二维斑点追踪成像(2D-STI)评价急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)治疗的效果,探讨梗死节段纵向应变(LS)峰值与高敏肌钙蛋白T (hs-cTnT)的相关性。方法选取2012年12月—2013年12月于佳木斯大学附属第一医院接受 PCI术的AMI患者40例为研究对象,按照心肌梗死部位分为急性前壁心肌梗死组(21例)和急性下壁心肌梗死组(19例)。分别于PCI术前及术后4周采用2D-STI技术测定心肌病变节段LS峰值,并测定hs-cTnT水平。结果 AMI患者PCI术前各病变节段运动幅度减低, LS-时间曲线形态杂乱;术后4周,各病变节段运动幅度略恢复, LS-时间曲线形态较规整。急性前壁心肌梗死组术前与术后4周前壁基底段、中间段和心尖段LS峰值比较,差异均有统计学意义( P<0.001)。急性下壁心肌梗死组术前与术后4周基底段、中间段和心尖段LS峰值比较,差异均有统计学意义( P<0.05)。急性前壁心肌梗死组术前hs-cTnT水平为404.2(344.0)μg/L,术后4周hs-cTnT水平为1.2(9.0)μg/L,差异有统计学意义(z=-4.015, P<0.001)。急性前壁心肌梗死组基底段、中间段和心尖段LS峰值变化与hs-cTnT水平变化均呈正相关(rs =0.74、0.75、0.74, P<0.001)。急性下壁心肌梗死组术前hs-cTnT水平为308.4(641.0)μg/L,术后4周hs-cTnT水平为1.9(2.6)μg/L,差异有统计学意义( z=-3.823, P<0.001)。急性下壁心肌梗死组基底段、中间段和心尖段LS峰值变化与hs-cTnT水平变化均呈正相关(rs=0.65、0.75、0.78, P<0.05)。结论 AMI患者PCI术后各节段LS峰值高于术前,且LS峰值变化与hs-cTnT水平变化有良好的相关性。2 D-STI可定量评价AMI患者PCI术前后心肌的运动功能,可作为评价PCI术疗效的良好方法。
目的:採用二維斑點追蹤成像(2D-STI)評價急性心肌梗死(AMI)患者經皮冠狀動脈介入(PCI)治療的效果,探討梗死節段縱嚮應變(LS)峰值與高敏肌鈣蛋白T (hs-cTnT)的相關性。方法選取2012年12月—2013年12月于佳木斯大學附屬第一醫院接受 PCI術的AMI患者40例為研究對象,按照心肌梗死部位分為急性前壁心肌梗死組(21例)和急性下壁心肌梗死組(19例)。分彆于PCI術前及術後4週採用2D-STI技術測定心肌病變節段LS峰值,併測定hs-cTnT水平。結果 AMI患者PCI術前各病變節段運動幅度減低, LS-時間麯線形態雜亂;術後4週,各病變節段運動幅度略恢複, LS-時間麯線形態較規整。急性前壁心肌梗死組術前與術後4週前壁基底段、中間段和心尖段LS峰值比較,差異均有統計學意義( P<0.001)。急性下壁心肌梗死組術前與術後4週基底段、中間段和心尖段LS峰值比較,差異均有統計學意義( P<0.05)。急性前壁心肌梗死組術前hs-cTnT水平為404.2(344.0)μg/L,術後4週hs-cTnT水平為1.2(9.0)μg/L,差異有統計學意義(z=-4.015, P<0.001)。急性前壁心肌梗死組基底段、中間段和心尖段LS峰值變化與hs-cTnT水平變化均呈正相關(rs =0.74、0.75、0.74, P<0.001)。急性下壁心肌梗死組術前hs-cTnT水平為308.4(641.0)μg/L,術後4週hs-cTnT水平為1.9(2.6)μg/L,差異有統計學意義( z=-3.823, P<0.001)。急性下壁心肌梗死組基底段、中間段和心尖段LS峰值變化與hs-cTnT水平變化均呈正相關(rs=0.65、0.75、0.78, P<0.05)。結論 AMI患者PCI術後各節段LS峰值高于術前,且LS峰值變化與hs-cTnT水平變化有良好的相關性。2 D-STI可定量評價AMI患者PCI術前後心肌的運動功能,可作為評價PCI術療效的良好方法。
목적:채용이유반점추종성상(2D-STI)평개급성심기경사(AMI)환자경피관상동맥개입(PCI)치료적효과,탐토경사절단종향응변(LS)봉치여고민기개단백T (hs-cTnT)적상관성。방법선취2012년12월—2013년12월우가목사대학부속제일의원접수 PCI술적AMI환자40례위연구대상,안조심기경사부위분위급성전벽심기경사조(21례)화급성하벽심기경사조(19례)。분별우PCI술전급술후4주채용2D-STI기술측정심기병변절단LS봉치,병측정hs-cTnT수평。결과 AMI환자PCI술전각병변절단운동폭도감저, LS-시간곡선형태잡란;술후4주,각병변절단운동폭도략회복, LS-시간곡선형태교규정。급성전벽심기경사조술전여술후4주전벽기저단、중간단화심첨단LS봉치비교,차이균유통계학의의( P<0.001)。급성하벽심기경사조술전여술후4주기저단、중간단화심첨단LS봉치비교,차이균유통계학의의( P<0.05)。급성전벽심기경사조술전hs-cTnT수평위404.2(344.0)μg/L,술후4주hs-cTnT수평위1.2(9.0)μg/L,차이유통계학의의(z=-4.015, P<0.001)。급성전벽심기경사조기저단、중간단화심첨단LS봉치변화여hs-cTnT수평변화균정정상관(rs =0.74、0.75、0.74, P<0.001)。급성하벽심기경사조술전hs-cTnT수평위308.4(641.0)μg/L,술후4주hs-cTnT수평위1.9(2.6)μg/L,차이유통계학의의( z=-3.823, P<0.001)。급성하벽심기경사조기저단、중간단화심첨단LS봉치변화여hs-cTnT수평변화균정정상관(rs=0.65、0.75、0.78, P<0.05)。결론 AMI환자PCI술후각절단LS봉치고우술전,차LS봉치변화여hs-cTnT수평변화유량호적상관성。2 D-STI가정량평개AMI환자PCI술전후심기적운동공능,가작위평개PCI술료효적량호방법。
Objective To evaluate the efficacy of PCI on patients with AMI by 2D -STI and to investigate the correlation between the peak value of longitudinal stain ( LS) of the infarction segment and hs-cTnT.Methods We enrolled 40 AMI patients who received PCI in the First Affiliated Hospital of Jiamusi University from December 2012 to December 2013.The subjects were divided into acute anterior wall myocardial infarction group ( n=21 ) and acute inferior wall myocardial infarction group (n=19).Before PCI and 4 weeks after PCI, the LS peak value of each myocardial segment was determined using 2D-STI, and hs-cTnT level was also examined .Results Before PCI, the motor extent of each lesion segment of the subjects decreased , and the LS-time curves were in disorder; four weeks after PCI , the extent of ventricular wall motion of each lesion segment recovered slightly , and the LS-time curve was in order .Four weeks after PCI , the LS peak values of the wall basal segment, middle segment and apical segment of acute anterior wall myocardial infarction group were significantly different ( P<0.001) from those before PCI.Four weeks after PCI, the LS peak values of the inferior wall basal segment , middle segment and apical segment of acute inferior wall myocardial infarction group were significantly different ( P<0.05 ) from those before PCI . The level of hs-cTnT of acute anterior wall myocardial infarction group was 404.2 ( 344.0 ) μg/L before PCI and was 1.2 (9.0) μg/L four weeks after PCI, with significantly different between them (z=-4.015, P<0.001).The change of LS peak values of the anterior wall basal segment , middle segment and apical segment of acute anterior wall myocardial infarction group were positively correlated with the change of hs-cTnT level (rs =0.74, 0.75, 0.74; P<0.001).The level of hs-cTnT of acute inferior wall myocardial infarction group was 308.4 ( 641.0 ) μg/L before PCI and was 1.9 ( 2.6 ) μg/L four weeks after PCI, with significant difference between them (z=-3.823, P<0.001).The change of LS peak values of the inferior wall basal segment , middle segment and apical segment of acute anterior wall myocardial infarction group were positively correlated with the change of hs-cTnT level (rs=0.65, 0.75, 0.78; P<0.05).Conclusion AMI patients have higher LS peak value of each segment than that before PCI , and the change of LS peak value has positive correlation with the change of hs-cTnT level.Through 2D-STI, quantitative evaluation could be conducted on the myocardial motor function in AMI patients before and after PCI.2D-STI is a good method for the efficacy evaluation of PCI .