摘要
目的应用二维斑点追踪显像（STI）技术评价急性心肌梗死（AMI）患者经皮冠状动脉介入（PCI）治疗前后不同时期左心室局部收缩功能的改变。方法 30例AMI患者接受PCI治疗,分别于PCI前、治疗后3~7天、治疗后3个月时采集左心室短轴及心尖切面图像。应用STI技术检测各梗死心肌节段应变参数：纵向、径向、圆周应变峰值（LSpeak、RSpeak、CSpeak）及达峰时间（TPSLS、TPSRS、TPSCS）;左心室短轴基底部、心尖部旋转角度峰值（Ptw base、Ptw apex）及旋转角度达峰时间（TPtw base、TPtwapex）;并计算左心室整体扭转角度峰值及扭转角度达峰时间（Ptw、TPtw）。另选30名正常人作对照,进行比较分析。结果 AMI患者PCI术前及术后各梗死心肌节段LSpeak、RSpeak、CSpeak较正常人减低,TPSLS、TPSRS、TPSCS较正常人延迟;Ptw base、Ptwapex、Ptw较正常人减低,TPtw base、TPtw apex、TPtw较正常人延迟（P均〈0.05）。与PCI治疗前比较,PCI治疗后3~7天内各梗死心肌节段LSpeak、RSpeak、CSpeak增高,TPSLS、TPSRS、TPSCS缩短（P均〈0.05）;PCI治疗后3个月上述指标变化更为显著（P均〈0.05）。与PCI治疗前比较,PCI后3~7天内Ptwbase、Ptwapex、TPtwbase、TPtwapex、Ptw、TPtw均无明显变化（P均〉0.05）。随着微循环再灌注时间的延长,PCI治疗后3个月时Ptw base、Ptwapex、Ptw较PCI治疗前及PCI治疗后3~7天内均有所增高,TPtw base、TPtwapex、TPtw亦缩短（P均〈0.05）。结论 PCI治疗能有效改善AMI患者左心室局部收缩功能,并随着时间的延长而改善明显。2D-STI可准确评价这一变化。
Objective To investigate the effect of percutaneous coronary intervention（PCI） on left ventricular regional systolic function in patients with acute myocardial infarction（AMI） by using two-dimensional speckle tracking imaging（2D-STI）.Methods Thirty patients with AMI underwent PCI,and left ventricular short axis and apex aspect images were acquired at baseline before PCI,3—7 days and 3 months after PCI.2D-STI was used to detect the systolic strain parameters of infarction： peak longitudinal,radial,circumferential strain（LSpeak,RSpeak,CSpeak） and the time to peak strain（TPSLS,TPSRS,TPSCS）;peak basal and apical rotation（Ptw base,Ptw apex） and the time to peak strain（TPtw base,TPtw apex）;peak left ventricular twist and the time to peak strain（Ptw,TPtw）.Thirty healthy controls were enrolled,and a comparative analysis was done.Results Compared with those of healthy controls,LSpeak,RSpeak,CSpeak decreased in each infarct stage in AMI patients,and TPSLS,TPSRS,TPSCS retarded;Ptw base,Ptw apex,Ptw were all smaller than those of healthy people,and TPtw base,TPtw apex,TPtw retarded（all P0.05）.Compared with the baseline,LSpeak,RSpeak,CSpeak increased in each infarct stage in AMI patients and TPSLS,TPSRS,TPSCS accelerated at 3—7 days after PCI（P0.05）,and the indexes changed more obviously 3 months after PCI（all P0.05）.Compared with the baseline,Ptw base,Ptw apex and TPtw base,TPtw apex;Ptw and TPtw were not significantly different at 3—7 days after PCI（P0.05）.With the extension of reperfusion,Ptw base,Ptw apex and Ptw at 3 months after PCI were all larger than those at baseline and 3—7 days after PCI;TPtw base,TPtw apex and TPtw accelerated（all P0.05）.Conclusion PCI can perfect the left ventricular regional systolic function in AMI patients,and with time going,the improvement becomes obviously.2D-STI can accurately evaluate this changing process.
出处
《中国医学影像技术》
CSCD
北大核心
2011年第2期308-312,共5页
Chinese Journal of Medical Imaging Technology
基金
辽宁医学院博士启动基金(20090811)
辽宁省自然科学基金(20102134)
关键词
斑点追踪显像
心肌梗死
心室功能
左
Speckle tracking imaging
Myocardial infarction
Ventricular function
left
