發(fā)布時(shí)間：2018-04-15 16:21

  本文選題：組織工程 + 冠狀血管��； 參考：《中國(guó)組織工程研究》2017年28期

【摘要】：背景:既往研究表明,組織多普勒成像技術(shù)、二維斑點(diǎn)追蹤成像技術(shù)等可無(wú)創(chuàng)地檢測(cè)冠狀動(dòng)脈粥樣硬化性心臟病變,但對(duì)無(wú)室壁運(yùn)動(dòng)異�；蚬跔顒�(dòng)脈粥樣硬化性心臟病早期患者,其敏感性和特異性均不高。近年發(fā)展的三維縱向應(yīng)變成像技術(shù),可克服上述缺點(diǎn),已成為目前比較成熟的一種定量評(píng)估心肌功能的新技術(shù)。而三維縱向應(yīng)變成像檢測(cè)的左室整體縱向峰值是預(yù)測(cè)高危冠狀動(dòng)脈粥樣硬化性心臟病較敏感的指標(biāo)。目的:觀察左室整體縱向峰值應(yīng)變值變化對(duì)老年高危冠狀動(dòng)脈粥樣硬化性心臟病的早期診斷價(jià)值。方法:研究為單中心、開(kāi)放性、診斷性試驗(yàn)。選取2013年1月至2018年1月湖北省十堰市太和醫(yī)院超聲科的疑似老年冠狀動(dòng)脈粥樣硬化性心臟病患者300例,按冠狀動(dòng)脈造影結(jié)果分為3組,低危組100例即右冠狀動(dòng)脈主干、左回旋支中一兩支狹窄≥70%,高危組100例即左冠狀動(dòng)脈主干狹窄≥50%或左前降支狹窄≥70%,對(duì)照組100例即冠狀動(dòng)脈主干及所有分支狹窄均50%。所有病例均行常規(guī)超聲心動(dòng)圖檢查后再應(yīng)用三維縱向應(yīng)變成像測(cè)量各組左室整體縱向峰值應(yīng)變值,并比較其差異。試驗(yàn)的主要觀察指標(biāo)為左室整體縱向峰值應(yīng)變值變化診斷冠狀動(dòng)脈粥樣硬化性心臟病的敏感度。試驗(yàn)的次要觀察指標(biāo)為左室整體縱向峰值應(yīng)變值變化診斷冠狀動(dòng)脈粥樣硬化性心臟病的特異度,陽(yáng)性預(yù)測(cè)值、陰性預(yù)測(cè)值、陽(yáng)性似然比、陰性似然比及診斷正確率;各組左室整體縱向峰值變化;各組常規(guī)超聲心動(dòng)圖各檢測(cè)參數(shù)變化;左室整體縱向峰值預(yù)測(cè)冠狀動(dòng)脈粥樣硬化性心臟病高危因素的ROC曲線變化。試驗(yàn)經(jīng)湖北省十堰市太和醫(yī)院倫理委員會(huì)批準(zhǔn)。研究符合世界醫(yī)學(xué)會(huì)制定的《赫爾辛基宣言》的要求。參與者本人對(duì)試驗(yàn)方案和過(guò)程均知情同意,并簽署知情同意書(shū)。試驗(yàn)倫理審批[審批單位:十堰市太和醫(yī)院,審批號(hào):倫理號(hào)2013第(03)號(hào)]為2013年1月,樣本及數(shù)據(jù)收集時(shí)間為2013年1月至2017年12月,結(jié)果指標(biāo)分析時(shí)間及試驗(yàn)完成時(shí)間為2018年1月。文章結(jié)果將以科學(xué)會(huì)議報(bào)告,或在同行評(píng)議的期刊上發(fā)表傳播。試驗(yàn)已在中國(guó)臨床試驗(yàn)注冊(cè)中心注冊(cè)(注冊(cè)號(hào):ChiCTR-DDD-17012839)。討論:試驗(yàn)希望證實(shí),三維縱向應(yīng)變成像可發(fā)現(xiàn)無(wú)室壁運(yùn)動(dòng)異常的疑診冠狀動(dòng)脈粥樣硬化性心臟病患者是否存在冠狀動(dòng)脈異常,其敏感性和特異性均較高,左室整體縱向峰值應(yīng)變值變化可對(duì)老年高危冠狀動(dòng)脈粥樣硬化性心臟病進(jìn)行早期診斷,這有助于幫助臨床醫(yī)師早期診斷該類冠狀動(dòng)脈粥樣硬化性心臟病患者并及時(shí)采取措施,盡可能避免發(fā)生嚴(yán)重的心血管不良事件。
[Abstract]:Background: previous studies have shown that tissue Doppler imaging and two-dimensional speckle tracking imaging can noninvasively detect coronary atherosclerotic heart disease.However, the sensitivity and specificity of the patients without abnormal ventricular wall motion or coronary atherosclerotic heart disease were not high.Three-dimensional longitudinal strain imaging developed in recent years can overcome these shortcomings and has become a mature new technique for quantitative evaluation of myocardial function.The global longitudinal peak of left ventricle measured by three dimensional longitudinal strain imaging is a sensitive index for predicting high risk coronary atherosclerotic heart disease.Objective: to observe the value of left ventricular global longitudinal peak strain in the early diagnosis of high risk coronary heart disease in the elderly.Methods: the study was monocentric, open and diagnostic.From January 2013 to January 2018, 300 suspected elderly patients with coronary atherosclerotic heart disease were selected from Department of Ultrasound, Taihe Hospital, Shiyan City, Hubei Province. According to the results of coronary angiography, 300 patients were divided into 3 groups.The stenosis of one or two branches in the left circumflex branch was 鈮，

本文編號(hào)：1754869