摘要
目的观察实时三维斑点追踪技术对无节段性室壁运动异常的早期冠心病患者左心室收缩功能评价的效果。方法选取2015年1月~2016年5月我院诊治的无节段性室壁运动异常的疑似冠心病患者120例,根据冠状动脉造影结果分为两组,将冠状动脉三支主干至少有一支狭窄≥50%者设为观察组,共73例,冠状动脉三支主干狭窄均<50%者设为对照组,共47例。利用三维斑点追踪技术测量2组左心室整体纵向应变值(GLS)、整体圆周应变值(GCS)、整体径向应变值(GRS)及整体面积应变值(GAS)。采用SPSS 18.0软件分析,绘制ROC曲线,计算各整体应变值的最佳截断值、敏感性、特异性;研究各参数与LVEF之间的相关性;对不同参数做一致性检验,比较观察者间与观察者内测值的差异。结果观察组采用实时三维斑点追踪技术测定左室GLS、GCS、GRS、GAS显著低于对照组(P<0.05)。ROC曲线示GAS具有更高的敏感性和特异性。当GAS在-28.3%为截断点时,敏感性为78.3%,特异性为67.5%。LVEF与GLS、GCS及GAS呈负相关(P<0.05);LVEF与GRS呈正相关(P<0.05)。结论实时三维斑点追踪技术能全面、准确检测无节段性室壁运动异常的早期冠心病患者左心室整体收缩功能。
Objective To observe the effect of real-time three dimensional speckle tracking technique for evaluating the left ventricular systolic function in coronary heart disease patients without regional wall motion abnormality. Methods 120 cases of suspected coronary heart disease without regional wall motion abnormality were selected in our hospital from January 2015 to May2016,these cases were divided into 2 groups according to angiography,three main artery at least one of coronary artery stenosis≥50% were selected as the observation group（n = 73）,and three main artery of coronary artery stenosis 50% were selected as the control group（n = 47）. Using real-time three dimensional speckle tracking technique,we measued 2 groups of global longitudinal strain value,global circumferential strain value,global radial strain value,global area strain value in left ventricular,and measured 2 groups of longitudinal strain value,circumferential strain value,radial strain value. SPSS 18. 0 software was used to analyze the data. We drew ROC curve and then calculated the optimal cut-off value,sensitivity and specificity of all global strain value. We studied the effect of the correlation between the different parameters,checked the consistency between the parameters and LVEF,compared the difference between the interobserver and the intraobserver. Results GLS,GRS,GCS and GAS in left ventricular using real-time three-dimensional speckle tracking in observation group,were significantly lower than the control group（P〈0. 05）; ROC curve showed that GAS had higher sensitivity and specificity. When optimal cut-off value of GAS was-28. 3%,sensitivity was 78. 3% and specificity was 67. 5%. LVEF was negatively correlated with GAS,GCS and GLS（P〈0. 05）; LVEF was positively correlated with GRS（P〈0. 05）. Conclusion Real-time three-dimensional speckle tracking technology can comprehensively and accurately detect left ventricular global and regional systolic function in early coronary heart disease patients without regional wall motion abnormality.
作者
黄卫飞
林仙方
杨林仙
HUANG Weifei;LIN Xianfang;YANG Linxian(Department of Ultrasound,Taizhou Hospital of Zhejiang Province,Taizhou 317000,P.R.China)
出处
《医学影像学杂志》
2018年第5期728-732,共5页
Journal of Medical Imaging
基金
浙江省医药卫生科技项目(编号:2015KYB441)
关键词
实时三维斑点追踪技术
冠心病
左心室收缩功能
Real time three dimensional speckle tracking technique
Coronary- atherosclerotic heart disease
Left ventricularsystolic function
