二维斑点追踪成像技术评价不同类型急性心肌梗死患者整体及节段室壁运动特点被引量：11

Characteristic of global and segmental wall motion in different types of acute myocardial infarction assessed by two-dimensional speckle tracking imaging

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摘要目的应用二维斑点追踪成像(STI)技术评价不同类型急性心肌梗死(AMI)患者室壁运动特点,探讨其评价心肌梗死的临床应用价值。方法选取95例初发确诊AMI患者(AMI组)及42例健康体检者(对照组),其中AMI组根据心电图特征分为非ST段抬高型(NSTEMI)亚组和ST段抬高型(STEMI)亚组(包括左室前壁、下壁及右室心肌梗死),比较各组常规超声参数及STI参数,并进行相关性分析。结果 AMI组左室收缩末期容积(LVESV)大于对照组,左室射血分数(LVEF)明显低于对照组,差异均有统计学意义(P<0.05);AMI组STEMI亚组右室心肌梗死患者右室射血分数(RVEF)低于对照组,差异有统计学意义(P<0.01),前壁心肌梗死与下壁心肌梗死患者LVEF比较未见明显差异;STEMI亚组LVEF低于NSTEMI亚组,差异有统计学意义(P<0.01);AMI组收缩期峰值纵向应变(LPSS)、峰值径向应变(RPSS)、峰值环向应变(CPSS)与对照组比较差异均有统计学意义(均P<0.01);NSTEMI亚组心外膜LPSS及CPSS均高于STEMI亚组,心内膜LPSS及CPSS均低于对照组,差异均有统计学意义(均P<0.01);STEMI亚组右室心肌梗死患者右室LPSS较对照组减低,差异有统计学意义(P<0.01)。一元和多元线性回归均显示,整体LPSS与LVEF相关性最好。结论 STI技术可准确评价不同类型AMI室壁节段性运动异常的特点,准确检测AMI的受累范围及程度,具有广泛的临床应用前景。 Objective To assess various characteristics of wall motion in patients with different types of acute myocardial infarction（AMI）by two-dimensional speckle tracking imaging（2D-STI）for exploration of clinical values of STI in diagnosis of AMI. Methods 95 first-onset AMI patients（AMI group）including non-ST-segment elevated（NSTEMI subgroup）and left ventricular anterior,inferior and right ventricular ST- segment elevated AMI（STEMI subgroup） and 42 cases of physical examination（control group）were enrolled for left ventricular longitudinal peak systolic strain（LPSS）,radial peak systolic strain（RPSS）,circumferential peak systolic strain（CPSS）and right ventricular LPSS（RV-LPSS） from 2D-STI. Results Compared with the control group,LVESV increased and LVEF decreased,the differences were statistically significant（all P 0.05）. The RVEF in STENI subgroup was lower than that of the control group,the difference was statistically significant（all P0.01）,anterior myocardial infarction and myocardial infarction in patients with LVEF,there was no obvious difference among the STEMI subgroups. LVEF was also lower than the NSTEMI subgroup,the difference was statistically significant（all P0.01）.The LPSS,RPSS,CPSS were statistically significant between the AMI group and control group（all P0.01）. LPSS and CPSS in NSTEMI subgroup were higher than that of epicardial STEMI subgroup,LPSS and CPSS in heart membranes were lower than the control group,the differences were statistically significant（all P0.01）.RV-LPSS patients in STEMI subgroup was lower than that of the control group,the difference was statistically significant（P0.01）. Univariate and multivariate linear regression showed the best correlationof the LPSS and LVEFF or the analysis of linear regression,global LPSS was better related to LVEF. Conclusion Parameters derived from STI are available for accurate recognition in various types of infarcted characteristics. STI has got the potential of clinical values to be an important modality for the diagnosis of AMI.

作者胡波陈金玲谭团团姚雪朱静静郭瑞强周青

机构地区武汉大学人民医院超声影像科

出处《临床超声医学杂志》 2016年第9期584-588,共5页 Journal of Clinical Ultrasound in Medicine

关键词超声心动描记术斑点追踪成像二维心肌梗死心室功能 Echocardiography Speckle tracking imaging two-dimensional Myocardial infarction Cardiac function

分类号 R542.22 [医药卫生—心血管疾病] R540.45 [医药卫生—心血管疾病]

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