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目的探讨超声二维斑点追踪显像(STI)技术测量二尖瓣环运动对冠心病患者左心室整体收缩功能评价的价值。方法根据冠状动脉造影(CAG)结果分为:冠心病组32例,至少一支主要冠状动脉狭窄≥50%且<100%;对照组30例为CAG结果正常者。所有受检者均接受常规超声心动图检查,取心尖四腔观、左室长轴观、两腔观二维动态图像,应用组织运动瓣环位移(TMAD)软件描绘二尖瓣环后间隔、侧壁、前间隔、后壁、前壁、下壁6个位点相对于心尖部的运动曲线,测量收缩期位移和速度,计算二尖瓣环同一切面两点收缩期平均位移(四腔观:TMDs4;左室长轴观:TMDs3;两腔观:TMDs2)、平均速度(四腔观:TMVs4;左室长轴观:TMVs3;两腔观:TMVs2),6个位点的平均位移(SMDs)、平均速度(SMVs)并进行比较。将SMDs、SMVs、TMDs4、TMDs3、TMDs2、TMVs4、TMVs3、TMVs2与简化双平面Simpson’s法所测得的左室射血分数(LVEF)进行相关性分析。结果冠心病组TMDs4、TMDs3、TMDs2、SMDs、TMVs4、TMVs3、TMVs2、SMVs均较对照组减低(分别为t=4.16,P<0.01;t=4.64,P<0.01;t=3.43,P<0.01;t=5.04,P<0.01;t=3.02,P<0.01;t=4.33,P<0.01;t=2.92,P<0.01;t=3.83,P<0.05)。结论 STI所测量的二尖瓣环收缩期位移和速度可以评价冠心病患者的左心室整体收缩功能。
Objective To investigate the value of two-dimensional speckle tracking imaging (STI) in the measurement of left ventricular systolic function in patients with coronary heart disease. Methods According to coronary angiography (CAG) results were divided into: coronary heart disease group of 32 patients, at least one major coronary artery stenosis ≥ 50% and <100%; control group of 30 patients with normal CAG results. All the subjects underwent routine echocardiography. The apical four-chamber view, the long-axis view of the left ventricle and the two-dimensional dynamic view of the two chambers were taken. The posterior mitral annulus was described by TMAD software. Side wall, anterior septum, posterior wall, anterior wall and inferior wall relative to the apex of the movement curve, measurement of systolic displacement and velocity, the same section of the mitral valve annulus to calculate the average systolic displacement of two points TMDs4; TMDs3; TMDs2), mean velocity (TMVs4 for four chambers; TMVs3 for TMVs3; TMVs2 for two chambers); average displacement of six sites (SMDs), average speeds (SMVs) and compared. Correlation analysis of left ventricular ejection fraction (LVEF) measured by SMDs, SMVs, TMDs4, TMDs3, TMDs2, TMVs4, TMVs3, TMVs2 and simplified biplane Simpson’s method was performed. Results The levels of TMDs4, TMDs3, TMDs2, SMDs, TMVs4, TMVs3, TMVs2 and SMVs in CHD group were significantly lower than those in the control group (t = 4.16, P <0.01, t = 4.64, ; t = 5.04, P <0.01; t = 3.02, P <0.01; t = 4.33, P <0.01; t = 2.92, P <0.01; t = 3.83, P <0.05). Conclusion STI measurements of mitral annulus systolic displacement and velocity can be evaluated in patients with coronary heart disease, left ventricular systolic function.