本文選題：三維斑點(diǎn)追蹤　切入點(diǎn)：應(yīng)變　出處：《蚌埠醫(yī)學(xué)院》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的： 應(yīng)用三維斑點(diǎn)追蹤顯像技術(shù)（3D-STI）聯(lián)合常規(guī)超聲心動(dòng)圖觀察冠狀動(dòng)脈粥樣硬化性心臟病，簡(jiǎn)稱冠心�。–AD）。經(jīng)皮冠狀動(dòng)脈介入(PCI)治療前后左室節(jié)段及整體收縮功能的變化，分析PCI治療對(duì)冠心病再灌注治療的短期療效，探討PCI對(duì)冠狀動(dòng)脈粥樣硬化性心臟病左室節(jié)段及整體收縮功能影響的三維斑點(diǎn)追蹤顯像技術(shù)評(píng)價(jià)。 方法： 分別對(duì)30例左心室射血分?jǐn)?shù)(LVEF)50%的冠狀動(dòng)脈粥樣硬化性心臟病患者進(jìn)行PCI治療，在患者接受治療前、治療后7天內(nèi)以及治療后3個(gè)月時(shí)及30例正常對(duì)照組進(jìn)行三維斑點(diǎn)追蹤顯像技術(shù)分析，測(cè)量出舒張末期左心室容血量（LVEDV）、收縮末期左心室容血量（LVESV）、左心室每搏輸出量占心室舒張末期容積量的百分比，即射血分?jǐn)?shù)(LVEF)及左室壁上的各個(gè)心肌節(jié)段在徑向、縱向、圓周三方面的應(yīng)變峰值(LSpeak、RSpeak、CSpeak)和達(dá)到峰值所需要的時(shí)間(TPSRS、TPSLS、TPSCS)。 結(jié)果： 與對(duì)照組比較，冠心病患者組PCI治療前后LVESV、LVEDV較對(duì)照組擴(kuò)大，LVEF比對(duì)照組降低，變化均有明顯統(tǒng)計(jì)學(xué)意義(P均0.05)。與PCI治療前比較，PCI后7天LVESV、LVEDV及LVEF都沒有明顯改變，變化無統(tǒng)計(jì)學(xué)意義(P均0.05)。PCI治療后3個(gè)月時(shí)LVESV、LVEDV比PCI治療前及PCI治療后7天內(nèi)都有一定的縮小，LVEF增高，變化均有統(tǒng)計(jì)學(xué)意義(P均0.05)。與對(duì)照組相比，冠心病患者組PCI治療前后各梗死心肌節(jié)段最大收縮期RSpeak、LSpeak、CSpeak比對(duì)照組降低，應(yīng)變峰值達(dá)峰時(shí)間TPSRS、TPSLS、TPSCS較對(duì)照組增加，變化有統(tǒng)計(jì)學(xué)意義(P均0.05)。與PCI治療前比較，，PCI治療后7天內(nèi)各梗死心肌節(jié)段最大收縮期RSpeak、LSpeak、CSpeak有一定增高，應(yīng)變峰值達(dá)峰時(shí)間TPSRS、TPSLS、TPSCS有一定減少，變化有統(tǒng)計(jì)學(xué)意義(P均0.05)；PCI治療后3個(gè)月后各梗死心肌節(jié)段最大收縮期RSpeak、LSpeak、CSpeak明顯增高，應(yīng)變峰值達(dá)峰時(shí)間TPSRS、TPSLS、TPSCS明顯減少，變化有統(tǒng)計(jì)學(xué)意義(P均0.05)。 結(jié)論： 1、冠心病患者由于冠狀動(dòng)脈阻塞引起相應(yīng)節(jié)段心肌的應(yīng)變明顯減低，左心室的一部分或者整體的收縮功能下降。 2、經(jīng)皮冠狀動(dòng)脈介入術(shù)治療后，血液會(huì)重新灌注缺血心肌，左心室收縮功能會(huì)隨著時(shí)間的推移恢復(fù)得越來越好。 3、3D-STI的優(yōu)點(diǎn)是能夠?qū)ψ笮氖颐總�(gè)區(qū)域的三維應(yīng)變值進(jìn)行快速的、準(zhǔn)確及定量的捕捉，并且能夠?qū)Ξ惓５淖笮氖沂冶谶\(yùn)動(dòng)進(jìn)行準(zhǔn)確的評(píng)估，從而對(duì)臨床中冠心病患者在左心室局部收縮功能異常的評(píng)價(jià)中提供無創(chuàng)、定量的方法。
[Abstract]:Objective:. Three-dimensional speckle tracing imaging (3D-STI) combined with conventional echocardiography was used to observe the changes of left ventricular segment and global systolic function before and after percutaneous coronary intervention (PCI) treatment for coronary atherosclerotic heart disease (CAD). To evaluate the effects of PCI on left ventricular segment and global systolic function in patients with coronary artery disease (CAD) and to evaluate the effects of PCI on left ventricular segment and global systolic function in patients with coronary artery disease (CHD). Methods:. 30 patients with left ventricular ejection fraction (LVEF) 50% of coronary atherosclerotic heart disease were treated with PCI. Three dimensional speckle tracing imaging was performed within 7 days after treatment, 3 months after treatment and 30 normal controls. Left ventricular volume (LVV), left ventricular volume (LVV), left ventricular volume (LVV) at the end of diastolic period (LVV), left ventricular volume (LVV) at the end of systolic period (LVV), left ventricular output (LVO) as a percentage of LVV (ejection fraction) and myocardial segments on the wall of the left ventricle (LVEF) were measured in radial and longitudinal directions. The strain peak in three aspects of the circle is LSpeak-RSpeak-CSpeak) and the time needed to reach the peak value is TPSRS / TPSLS / TPSCS. Results:. Compared with the control group, the LVESVV / LVEDV in the CHD group was lower than that in the control group before and after PCI treatment, and the changes were statistically significant (P < 0.05). There were no significant changes in LVESVV, LVEDV and LVEF 7 days after PCI treatment in patients with coronary heart disease. There was no significant difference in the changes of LVEVDV between before and after PCI treatment and within 7 days after PCI treatment (P < 0.05, P < 0.05). Compared with the control group, the changes of LVEDV were significantly higher than those before PCI treatment and within 7 days after PCI treatment, and the changes were significantly higher than those in the control group (P < 0.05). Before and after PCI treatment, the maximal systolic phase of myocardial infarction in coronary heart disease group was lower than that in the control group, and the peak strain peak time (TPSRS) was higher than that in the control group. The changes were statistically significant (P < 0.05), compared with those before PCI treatment, the maximal systolic peak of myocardial segments in each infarct was increased in 7 days after PCI, and the peak strain peak time (TPSRS) was decreased, and the peak strain peak time (TPSSRS) was decreased. The changes were statistically significant (P < 0.05). After 3 months of PCI, the maximal systolic peak value of RSpeaker-LSpeak-LSpeak-CSpeak was significantly increased, and the peak strain peak time (TPSRS) of TPSLSS-TPSLSSCS was significantly decreased (P < 0.05). Conclusion:. 1. In patients with coronary heart disease, the strain of the corresponding segment of myocardium was significantly decreased and the systolic function of the left ventricular part or whole was decreased due to coronary artery occlusion. 2. After percutaneous coronary intervention, the blood reperfuses the ischemic myocardium, and the left ventricular systolic function recovers over time. 3D-STI has the advantage of fast, accurate and quantitative capture of the three dimensional strain values in each region of the left ventricle, and an accurate assessment of the abnormal left ventricular wall motion. Therefore, it provides a noninvasive and quantitative method for the evaluation of left ventricular regional systolic dysfunction in patients with coronary heart disease.
【學(xué)位授予單位】：蚌埠醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R445.1;R541.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 王金銳,王世宏,劉志躍,秦林金,楊海萍;應(yīng)變積分曲線評(píng)價(jià)心梗病人左室局域舒張功能[J];中國(guó)醫(yī)學(xué)影像技術(shù);2002年11期

2 楊穎;陳峰;張寶娓;齊麗彤;趙鋒;何萍;;二維應(yīng)變對(duì)左心室整體應(yīng)變與應(yīng)變率的研究[J];中國(guó)醫(yī)學(xué)影像技術(shù);2006年07期

本文編號(hào)：1609759