摘要
目的探讨利用二维应变检测冠状动脉粥样硬化性心脏病(冠心病)患者区域室壁收缩功能价值。方法对42例冠心病患者按照冠状动脉(冠脉)供血区室壁计算如下参数:左室区域峰值应变(Ter-PSS),区域室壁收缩指数(Ter-WMSI),区域组织收缩峰值速度(Ter-TVI),计算无狭窄冠脉、轻-中度狭窄冠脉(狭窄率<75%)所供血室壁之间各参数变化,并计算各参数鉴别冠脉重度狭窄与轻-中度狭窄的敏感性、特异性、准确性。同时选取15例正常人做对照分析。结果 (1)重度狭窄供血区Ter-PSS与轻-中度狭窄Ter-PSS、无狭窄Ter-PSS差异均有统计学意义(均P<0.01)。重度狭窄供血区Ter-WMSI与轻-中度狭窄Ter-WMSI、无狭窄Ter-WMSI差异均有统计学意义(均P<0.01)。重度狭窄Ter-TVI与轻-中度狭窄Ter-TVI、无狭窄Ter-TVI间差异均无统计学意义(均P>0.05)。(2)诊断冠脉重度狭窄ROC曲线下面积(AUC):Ter-PSS、Ter-WMSI、Ter-TVI分别为0.794、0.752、0.533,Ter-PSS、Ter-WMSI取最佳界值点-12.5%、1.2时敏感性、特异性分别为73.8%、88.0%;67.2%、76.0%。结论冠心病组Ter-PSS、Ter-TVI均低于正常对照组,Ter-WMSI明显高于对照组,Ter-PSS、Ter-WMSI能较准确鉴别冠脉重度狭窄与轻-中度狭窄,且Ter-PSS敏感性、特异性均高于Ter-WMSI。
Objective To discuss the diagnostic value of terriorial systolic function in patients with coronary disease（CAD） by two-dimensional territorial strain（Ter-Strain）. Methods Left ventficular（LV） territorial peak systolic strain（Ter-PSS）, territorial wall systolic index（Ter＇-WSI） and territorial tissue velocity imaging（Ter-TVI） in 42 CAD patients confirmed by coronary artery（CA） graphy were calculated. Patients with CAD were divided into three sub- groups： non-stenosis, mild-middle stenosis and severe stenosis group, and the three factors（Ter-PSS, Ter-WSI and Ter-TVI） were compared respectively to get the sensitivity, specificity and accuracy between servere stenosis and mild-middle stenosis. 15 normal cases were seclected as the control group. Results Ter-PSS and Ter-TVI in patients with CAD were lower than those in the normal group. Ter-WSI was higher than that in the normal group. There was statistical difference on Ter-PSS between the Mood-supplying area in severe stenosis group[（- 9.55±6.54）%] and the mild-middle stenosis[（- 16.29±5.74）%] as well as the non-stenosis group [（-- 15.33±5.07）%] （P 〈 0.01）. There was no statistical difference between mild-middle and non-stenosis group（P=-0.42）. There was statistical difference on Ter-WSI between the blood-supplying area in severe stenosis group（1.74±0.62） and mild-middle stenosis group （ 1.18±0.31 ） as well as the non-stenosis group （ 1.30±0.48 ） （P 〈 0.01）. There was no statistical difference on the Ter-TVI among the severe stenosis, mild-middle and nonstenosis group. The area of Ter-PSS,Ter-WSI and Ter- TVI under the ROC curve in diagnosing severe CA stenosis were 0.794, 0.752 and 0.533 respectively. Sensitivity and specificity were 73.8% and 88.0% when the best cut-point of Ter-PSS was -12.5%, and 67.2% and 76.0% when the best cut-point of Ter-WSI was 1.20. Conclusions Ter-PSS and Ter-WSI can differentiate severe stenosis from mild-middle stenosis accurately. Sensitivity and specif
出处
《现代实用医学》
2010年第12期1333-1336,共4页
Modern Practical Medicine
基金
浙江省医学会临床科研基金项目
编号:NO2009ZYC27
关键词
冠状动脉疾病
冠状动脉狭窄
超声检查
二维应变
区域应变
Coronary artery disease
Coronary artery stenosis
2-Dimensional speckle tracking imaging
2-dimensional Strain
Terfitoral strain,
