实时三维经胸超声心动图定量评价正常成人左心室-1pdfnet.DOC

PAGE PAGE 9 斑点追踪成像评价冠心病患者CABG或PCI术治疗前后左室收缩功能 王丽萍，夏红梅，蒋 演，任 冰，李晓渝，高云华 （400037 重庆，第三军医大学新桥医院超声科） [摘要] 目的 应用斑点追踪成像技术(STI)评价冠心病患者行冠脉内支架置入术(percutaneous coronary intervention, PCI)或冠脉搭桥术(coronary artery by pass grafting， CABG)前后不同阶段左心室的局部和整体收缩功能。方法 选取确诊为冠心病并接受PCI 治疗的患者35 例，接受CABG手术治疗的患者30 例，分别于手术前3d、术后1、3、6个月时行超声心动图检查，采集相应时间点的左心室二维图像；另选年龄性别相匹配的48名健康者作为正常对照组；比较分析其常规超声心动图参数、二维应变参数的变化差异，以及各组在各时间点内的相关性。结果 （1）冠心病PCI组及CABG组术前常规心脏超声参数（E/A、LVEFSTI），参数(GBLS、GBRS 、GBCS 、Prot apex、Prot base、Ptw）均显著低于正常对照组(P0.05)； （2）冠心病PCI组术后1、3、6个月各阶段的参数值均较术前增高且呈递增趋势，但仍低于正常对照组(P0.05)；术后各阶段参数值与术前比较，差异均具有统计学意义(P0.05)；（3）冠心病CABG组术后3、6个月STI参数与正常组比较，差异有统计学意义(P0.05)，但术后1个月测值较术前比较无明显改善 (P0.05)；(4)PCI及CABG组的GBLS、GBRS、GBCS均与LVEF显著性相关（P0.01）。结论 STI可以定量评价冠心病患者行PCI或CABG手术治疗前后左室整体及局部收缩功能，对评价治疗效果及预后具有重要的临床价值。 [关键词] 斑点追踪成像；冠心病；冠脉搭桥术；冠状动脉内支架置入术；二维应变 [中图法分类号] [文献标志码] A Speckle tracking imaging in the evaluation of Left ventricular systolic function in patients with coronary heart disease before and after PCI or CABG Wang Liping，Xia Hongmei，Jiang Yan，Ren Bing，Li Xiaoyu，Gao Yunhua(Department of ultrasonography, Xinqiao hospital, Third military medical university，Chongqing，400037，China) [Abstract] Objective To assess regional and global left ventricular systolic function in patients with coronary heart diseases (CAD) before and after PCI or CABG by speckle tracking imaging. Methods Echocardiography was performed in thirty-five patients by PCI and thirty patients by CABG with CAD before and 1month、3months、6months after therapy. Forty-eight healthy persons were performed as normal controls. Results Parameters both of conventional echocardiography (E/A、LVEF) and STI (GBLS、GBRS 、GBCS 、Prot apex、Prot base、Ptw）with CAD before PCI or CABG were significantly lower than that of the control group (P0.05). Parameters of 1month、3 months、6months after PCI were higher than that of before therapy and showed an increasing trend，but still lower than the control group (P0.05)；Compared w