摘要
目的:探讨超声心动图斑点追踪成像(STI)对急性ST段抬高型心肌梗死(STEMI)患者心肌缺血再灌注损伤的诊断价值。方法:回顾性分析2019年8月至2022年8月该院收治的85例STEMI患者的临床资料,统计患者经皮冠状动脉介入术(PCI)后心肌再灌注损伤发生情况,依据是否发生心肌缺血再灌注损伤分为发生组、未发生组,比较两组超声心动图常规参数[左心室射血分数(LVEF)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、三尖瓣口舒张早期血流速度峰值(E)及舒张末期血流速度峰值(A)],STI技术参数[纵向应变(LS)、径向应变(RS)及圆周应变(CS)],并采用受试者工作特征(ROC)曲线评估超声心动图常规参数、STI技术参数及联合检测对心肌缺血再灌注损伤的诊断价值。结果:85例患者经PCI治疗后,31例发生再灌注损伤,发生率为36.47%;发生组LVEF水平低于未发生组,LVEDV、LVESV值大于未发生组,差异均有统计学意义(P<0.05);两组E、A值比较,差异均无统计学意义(P>0.05);发生组LS、CS、RS峰值均低于未发生组,差异有统计学意义(P<0.05);ROC曲线分析结果显示,LS、CS、RS诊断心肌缺血再灌注损伤的曲线下面积(AUC)均>0.7,具有一定诊断价值,高于LVEF、LVEDV、LVESV的AUC,而常规参数和STI参数联合检测诊断心肌缺血再灌注损伤的AUC>0.9,诊断价值较高。结论:超声心动图STI技术可用于评估STEMI患者心肌缺血再灌注损伤的发生情况,与超声心动图常规参数联用可提高诊断价值。
Objective:To investigate diagnostic value of echocardiography speckle-tracking imaging(STI)in myocardial ischemia reperfusion injury in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods:The clinical data of 85 patients with STEMI admitted to the hospital from August 2019 to August 2022 were retrospectively analyzed.The incidence of myocardial reperfusion injury after percutaneous coronary intervention(PCI)was statistically analyzed.According to whether myocardial ischemia reperfusion injury occurred,they were divided into occurrence group and non-occurrence group.The conventional echocardiographic parameter levels[left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),peak early diastolic blood flow velocity(E)and peak end-diastolic blood flow velocity(A)]and the STI technical parameter levels[longitudinal strain(LS),radial strain(RS)and circumferential strain(CS)]were compared between the two groups.The receiver operating characteristic curve(ROC)was used to evaluate the diagnostic value of conventional echocardiographic parameters,STI technology and combined detection for myocardial ischemia-reperfusion injury.Results:After PCI treatment,31 of 85 patients had reperfusion injury with an incidence of 36.47%.The LVEF level in the occurrence group was lower than that in the non-occurrence group,the LVEDV and LVESV values were higher than those in the non-occurrence group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in the E and A values between the two groups(P>0.05).The LS,CS,and RS peak values in the occurrence group were lower than those in the non-occurrence group,and the differences were statistically significant(P<0.05).The ROC curve results show that the areas under the curve(AUC)of LS,CS,and RS for diagnosing myocardial ischemia reperfusion injury were all greater than 0.7,indicating they had certain diagnostic;these values were higher than
作者
汤文芳
TANG Wenfang(Department of Ultrasound of Xiayi County People’s Hospital,Shangqiu 476400 Henan,China)
出处
《中国民康医学》
2023年第10期127-130,共4页
Medical Journal of Chinese People’s Health
关键词
超声心动图
斑点追踪成像
急性ST段抬高型心肌梗死
心肌缺血
再灌注损伤
Echocardiography
Speckle tracking imaging
Acute ST-segment elevation myocardial infarction
Myocardial ischemia
Reperfusion injury
