本文關(guān)鍵詞： 超聲心動(dòng)描記術(shù) 心肌梗死 心室重構(gòu)　出處：《中國(guó)循環(huán)雜志》2017年03期 　論文類(lèi)型：期刊論文

【摘要】：目的:評(píng)價(jià)斑點(diǎn)追蹤超聲心動(dòng)圖(STE)判斷急性ST段抬高型心肌梗死(STEMI)并接受擇期經(jīng)皮冠狀動(dòng)脈介入治療(PCI)患者是否發(fā)生左心室重構(gòu)的價(jià)值。方法:共入選127例首次STEMI并接受擇期PCI的患者,入院后48 h內(nèi)行超聲心動(dòng)圖檢查。出院后隨訪(fǎng)6~9個(gè)月(中位數(shù)為7.8個(gè)月),復(fù)查超聲心動(dòng)圖,左心室重構(gòu)的定義為左心室收縮末期容積較初次測(cè)量增加15%。根據(jù)127例患者是否發(fā)生左心室重構(gòu)分為兩組,41例發(fā)生左心室重構(gòu)患者為左心室重構(gòu)組,另86例患者為無(wú)左心室重構(gòu)組。結(jié)果:左心室重構(gòu)組和無(wú)左心室重構(gòu)組兩組間比較,左心室壁總體縱向應(yīng)變、縱向應(yīng)變達(dá)峰時(shí)間標(biāo)準(zhǔn)差(Ts-SD)、徑向應(yīng)變、縱向左心室收縮后收縮指數(shù)等均有顯著差異。進(jìn)一步Logistic回歸分析表明,總體縱向應(yīng)變[比值比(OR)=0.39,95%可信區(qū)間(CI):0.26~0.57,P0.01]及徑向應(yīng)變(OR=1.07,95%CI:1.02~1.13,P=0.01)是預(yù)測(cè)STEMI并接受擇期PCI的患者發(fā)生左心室重構(gòu)的獨(dú)立預(yù)測(cè)因素,受試者工作特征(ROC)曲線(xiàn)分析顯示二者的最佳界值分別為-10.85%(敏感性:89.7%,特異性:91.7%)及28.46%(敏感性:82.1%,特異性:66.7%)。結(jié)論:應(yīng)用STE獲得的左心室壁總體縱向應(yīng)變及徑向應(yīng)變等是預(yù)測(cè)STEMI并行擇期PCI后發(fā)生左心室重構(gòu)的獨(dú)立相關(guān)因素。
[Abstract]:Objective: to evaluate the value of dot-tracing echocardiography (STE) in judging whether left ventricular remodeling occurred in patients with acute ST-segment elevation myocardial infarction (STEMI) and undergoing selective percutaneous coronary intervention (PCI). Methods: 127 patients with acute ST-segment elevation myocardial infarction (STEMI) were enrolled for the first time. Patients with STEMI who received elective PCI, Echocardiography was performed within 48 hours after admission and followed up for 6 to 9 months (median 7.8 months) after discharge. Left ventricular remodeling is defined as the increase of left ventricular end-systolic volume by 15 percent over the initial measurement. According to whether 127 patients have left ventricular remodeling, they are divided into two groups: 41 patients with left ventricular remodeling. Results: the left ventricular remodeling group and the left ventricular remodeling group were compared. The total longitudinal strain of left ventricular wall, the standard deviation of peak time of longitudinal strain and radial strain were compared between the left ventricular remodeling group and the left ventricular remodeling group. There were significant differences in longitudinal left ventricular systolic index after contraction. Further Logistic regression analysis showed that, The overall longitudinal strain [ratio of 0.39% 95% confidence interval] and the radial strain ratio of 1.07% to 1.13% P0.01 were independent predictors of left ventricular remodeling in patients with STEMI and accepted selective PCI. The analysis of the operating characteristics of the subjects showed that the optimum boundary values of the two were -10.85 (sensitivity 89.7, specificity 91.7) and 28.4646 (sensitivity 82.1 and specificity: 66.7) respectively. Conclusion: the total longitudinal and radial strain of left ventricular wall obtained by STE are preconditioned. Independent factors related to left ventricular remodeling after STEMI combined with selective PCI.
【作者單位】： 大連醫(yī)科大學(xué)附屬第二醫(yī)院重癥監(jiān)護(hù)室;大連醫(yī)科大學(xué)附屬第一醫(yī)院心血管病院;
【基金】：大連市科技計(jì)劃項(xiàng)目(2014E14SF173)
【分類(lèi)號(hào)】：R540.45;R542.22

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