本文選題：斑點追蹤成像 + 應(yīng)變��； 參考：《暨南大學(xué)》2017年碩士論文

【摘要】：目的探討二維斑點追蹤成像(STI)技術(shù)是否可以評價射血分數(shù)保留的急性前壁心肌梗死后左心室重構(gòu)。方法50例射血分數(shù)保留的急性前壁心肌梗死患者,入院后立即行超聲心動圖檢查,并于經(jīng)皮冠狀動脈介入治療(PCI)術(shù)后6個月后根據(jù)有無左室重構(gòu)分為兩組,檢測兩組心尖各切面(兩腔心、三腔心、四腔心切面)左室心肌縱向峰值收縮應(yīng)變(LS)、縱向峰值收縮應(yīng)變率(LSR)、縱向峰值收縮總應(yīng)變(GLS)、縱向峰值收縮總應(yīng)變率(GLSR)、受損縱向應(yīng)變(Inj LS)、受損縱向應(yīng)變率(Inj LSR);檢測兩組左室舒張末期容積(LVEDV)、收縮末期容積(LVESV)、左室射血分數(shù)(LVEF)、室壁運動積分指數(shù)(WMSI)、舒張早期二尖瓣血流速度/舒張早期二尖瓣環(huán)運動速度(E/e’);分析左室重構(gòu)組的LVESV、LVEDV、LVEF、WMSI、E/e’等超聲心動圖參數(shù)與縱向峰值收縮總應(yīng)變(LS)、縱向峰值收縮總應(yīng)變率(LSR)、受損縱向應(yīng)變(Inj LS)、受損縱向應(yīng)變率(Inj LSR)的相關(guān)性,并對縱向峰值收縮總應(yīng)變(LS)、縱向峰值收縮總應(yīng)變率(LSR)、受損縱向應(yīng)變(Inj LS)、受損縱向應(yīng)變率(Inj LSR)的進行ROC曲線分析。結(jié)果左室重構(gòu)組與非左室重構(gòu)組的左室收縮末期容積增加量百分比(△LVESV%)、左室舒張末期容積增加量百分比(△LVEDV%)、WMSI、E/e’值的差別有統(tǒng)計學(xué)意義,P0.05;左室重構(gòu)組的縱向峰值收縮總應(yīng)變與LVEF(r=0.96,P0.01)呈正相關(guān),縱向峰值收縮總應(yīng)變率與LVEF(r=0.97,P0.01)呈正相關(guān),受損縱向應(yīng)變與LVEF(r=0.81,P0.01)呈正相關(guān),受損縱向應(yīng)變率亦與LVEF(r=0.95,P0.01)呈正相關(guān)。縱向峰值收縮總應(yīng)變≥-14%時,診斷射血分數(shù)保留的急性前壁心肌梗死后左室重構(gòu)的敏感度為88.2%,特異度為87.9%;縱向峰值收縮總應(yīng)變率≥-1.1 S-1時,診斷射血分數(shù)保留的急性前壁心肌梗死后左室重構(gòu)的敏感度為94.1%,特異度為42.4%;受損縱向應(yīng)變≥-11%時,診斷射血分數(shù)保留的急性前壁心肌梗死后左室重構(gòu)的敏感度為88.2%,特異度為63.6%;受損縱向應(yīng)變率≥-1.0 S-1時,診斷射血分數(shù)保留的急性前壁心肌梗死后左室重構(gòu)的敏感度為88.2%,特異度為69.7%。結(jié)論(1)斑點追蹤成像技術(shù)可以初步評價射血分數(shù)保留的急性前壁心肌梗死患者的左室形變、心肌局部和整體功能。(2)斑點追蹤成像技術(shù)可以成為定量評價射血分數(shù)保留的急性前壁心肌梗死后左室重構(gòu)及臨床預(yù)后提供重要預(yù)測信息。(3)結(jié)合縱向峰值收縮總應(yīng)變及受損縱向應(yīng)變、受損縱向應(yīng)變率可以更好地預(yù)測射血分數(shù)保留的急性前壁心肌梗死后左室重構(gòu)。
[Abstract]:Objective to investigate whether two-dimensional speckle tracking imaging (STI) can evaluate left ventricular remodeling after acute anterior myocardial infarction (AMI) with retained ejection fraction (EF).Methods Fifty patients with acute anterior wall myocardial infarction with retained ejection fraction were examined by echocardiography immediately after admission and divided into two groups according to left ventricular remodeling 6 months after percutaneous coronary intervention (PCI).Two groups of apical sections (two cavities, three cavities) were detected.Four-chamber section) left ventricular myocardial longitudinal peak systolic strain (LSN), longitudinal peak systolic strain rate (LSRR), longitudinal peak systolic total strain (GLSN), longitudinal peak systolic total strain rate (GLSRN), damaged longitudinal strain (Inj LSN), damaged longitudinal strain rate (LSR) and Inj LSRG;The left ventricular end-diastolic volume (LVEDVV), end-systolic volume (LVESVV), left ventricular ejection fraction (LVEF), wall motion integral index (WMSI), early diastolic mitral flow velocity / early diastolic mitral annular velocity (E / E) in the left ventricular remodeling group were analyzed.The correlation between the parameters of isoechocardiography and the total strain of the longitudinal peak contraction, the total strain rate of the longitudinal peak contraction, the damaged longitudinal strain, the damaged longitudinal strain rate and the damage of the longitudinal strain rate (Inj LSRs).The ROC curves were analyzed for the total strain of longitudinal peak contraction, the total strain rate of longitudinal peak contraction, the damaged longitudinal strain, the damaged longitudinal strain and the damaged longitudinal strain rate.Results there was significant difference between left ventricular remodeling group and non-left ventricular remodeling group in left ventricular end-systolic volume (LVESVV) and left ventricular end-diastolic volume increment (LVEDVV) (P < 0.05), and the longitudinal peak of left ventricular remodeling group (LVEVV) was significantly higher than that of non-left ventricular remodeling group (P < 0.05), and there was a significant difference between left ventricular remodeling group and non-left ventricular remodeling group (P < 0.05).There was a positive correlation between the total strain of value contraction and that of LVEF ru 0.96g P 0.01).There was a positive correlation between the total strain rate of longitudinal peak contraction and that of LVEFN 0.97 (P0.01), a positive correlation between the damaged longitudinal strain and LVEF0.81 (P0.01), and a positive correlation between the damaged longitudinal strain rate and LVEF0.95 (P0.01).When the total longitudinal peak systolic strain 鈮，

本文編號：1746750