摘要
目的应用应变率显像技术（SRI）评价经皮冠状动脉介入治疗（PCI）前后冠心病患者的左心室局部功能变化。方法在28例冠心病患者中,分别于PCI前、PCI后1周和1个月行经胸超声心动图检查,应用SRI技术对左室心尖四腔观及两腔观各节段的心内膜下心肌和心外膜下心肌局部心功能进行定量分析。根据冠状动脉造影结果将心肌节段分为：正常组,冠脉狭窄1级组、2级组、3级组和4级组（冠脉狭窄分别为〈50%、50%～75%、76%～99%和100%）。结果①PCI术前：2、3、4级组的心内膜下心肌和心外膜下心肌收缩期（S）、舒张早期（E）和舒张晚期（A）最大应变率（SRS、SRE、SRA）与正常组测值相比均降低（P〈0.05）;4级组心内膜下心肌和心外膜下心肌SRS、SRE和SRA均小于2级组（P〈0.05）。在正常组和1级组心内膜下心肌的SRS、SRE和SRA均大于心外膜下心肌的测值,差别有统计学意义（P〈0.05）;在2、3、4级组心内膜下心肌SRS、SRE和SRA与心外膜下心肌的测值比较差别无统计学意义（P〉0.05）。②PCI术后：3组和4组于PCI术后1周和1个月时心内膜下心肌和心外膜下心肌的SRS、SRE和SRA均较PCI术前增加（P〈0.05）,3级组心内膜下心肌的SRE和SRA大于心外膜下心肌的测值,差别有统计学意义（P〈0.05）;在3组,术后1周和1个月时心内膜下SRS和SRE变化率均明显大于心外膜下心肌（P〈0.05）;在4组,术后1周和1个月时心外膜下心肌SRS、SRE和SRA的变化率均明显大于心内膜下心肌,差别有统计学意义（P〈0.05）。结论应用SRI技术测量心内膜下心肌和心外膜下心肌的应变率可定量评价冠心病患者缺血心肌的局部功能,动态观察PCI前、后局部心肌功能变化,评价PCI的治疗效果。
Objective To evaluate left ventricular regional myocardial function quantitatively before and after percutaneous coronary intervention（PCI）in patients with coronary artery disease（CAD）by strain rate imaging（SRI）.Methods In 28 patients with CAD transthoracic echocardiographic views at the apical level were obtained before and after PCI.The regional myocardial function was measured by SRI in subendocardial and subepicardial layers of the left ventricular at apical four-chamber view and two-chamber view.Left ventricular segments were devided into normal group and CAD groups 1,2,3,4（coronary artery stenosis 〈50%,50%～75%,76%～99% and 100%,respectively）.Results ①Before PCI,both subendocardial and subepicardial peak strain rate（SR）in the systole（SRS）,early diastole（SRE）and late diastole（SRA）were decreased significantly in groups 2,3 and 4 compared with normokinetic segments of normal coronary artery（P〈0.05）;The peak SRS,SRE and SRA of subendocardial and subepicardial layers were lower in group 4 than group 2（P〈0.05）;The subendocardial peak SRS,SRE and SRA were higher than subepicardium（P〈0.05）in control group and group 1.②After PCI,the subendocardial and subepicardial SRS,SRE and SRA were higher significantly than that before PCI in groups 3 and 4（P〈0.05）.The subendocardial SRE and SRA were higher than subepicardial values in group 3（P〈0.05）.The rate of subendocardial SRS and SRE changes were greater than subepicardial values in group 3（P〈0.05）,however,the rate of endocardial SRS,SRE and SRA changes were smaller than subepicardial values in group 4（P〈0.05）.Conclusions The subendocardial and subepicardial SR could evaluate the regional myocardial function of ischemic myocardium quantitatively and determine the therapeutic efficacy of PCI in patients with CAD.
出处
《中华超声影像学杂志》
CSCD
2007年第11期926-930,共5页
Chinese Journal of Ultrasonography
基金
资助项目：山东省科技攻关项目（2006GG2202039）、山东省医学科技攻关项目（2005HZ048）及山东省卫生系统高层次人才1020工程资助
关键词
超声心动描记术
心室功能
左
心肌缺血
血管成形术
经腔
经皮冠状动脉
应变率显像
Echocardiography
Ventricular function,left
Myocardial ischemia
Angioplasty,transluminal,percutaneous coronary
Strain rate imaging
