本文選題：三維斑點(diǎn)追蹤技術(shù) + 急性心肌梗死��； 參考：《吉林大學(xué)》2017年碩士論文

【摘要】：目的:利用實(shí)時(shí)三維斑點(diǎn)追蹤技術(shù)(three dimensional speckle tracking imaging,3D-STI)評(píng)價(jià)中老年急性心肌梗死患者經(jīng)皮冠狀動(dòng)脈介入治療術(shù)(percutaneous coronary intervention,PCI)后心肌各節(jié)段應(yīng)變、左室整體應(yīng)變、左室旋轉(zhuǎn)、左室扭轉(zhuǎn)、左室扭力與左心室整體收縮功能,闡明其PCI術(shù)后早期心肌應(yīng)變及扭轉(zhuǎn)、旋轉(zhuǎn)參數(shù)改變特點(diǎn)及其臨床價(jià)值。材料與方法:選取因左前降支病變行PCI術(shù)患者30例納入病例組,同期選取健康中老年人30例納入對(duì)照組,常規(guī)獲取二維超聲資料后,運(yùn)用三維斑點(diǎn)追蹤技術(shù)對(duì)兩組受試者進(jìn)行心肌運(yùn)動(dòng)及收縮功能檢測(cè),收集左心室各節(jié)段及整體縱向應(yīng)變(global longitudinal strain,GLS)、徑向應(yīng)變(global radial strain,GRS)、圓周應(yīng)變(global circumferential strain,GCS)和面積應(yīng)變值(global area strain,GAS)、左心室基底平面各個(gè)節(jié)段的收縮期扭轉(zhuǎn)角度峰值(peak basal twist peak apical twist,Ptw-B),左心室心尖平面的各個(gè)節(jié)段的扭轉(zhuǎn)角度峰值(peak apical twist,Ptw-A),左心室整體扭轉(zhuǎn)角度峰值(left ventricular twist,LVtw),左心室基底平面各個(gè)節(jié)段的旋轉(zhuǎn)角度峰值(peak basal rotation,Prot-B),左心室心尖平面的各個(gè)節(jié)段的旋轉(zhuǎn)角度峰值(peak apical rotation,Prot-A),左心室整體旋轉(zhuǎn)角度峰值(left ventricular rotation,LVrot),左心室基底平面的各個(gè)節(jié)段扭力峰值(peak basal torsion,Ptor-B),左心室心尖平面的各個(gè)節(jié)段的扭力峰值(peak apical torsion,Ptor-A),左心室整體扭力峰值(left ventricular rotation,LVtor),左室射血分?jǐn)?shù)(left ventricular ejection fraction,LVEF)。結(jié)果:1.與對(duì)照組比較,病例組整體應(yīng)變值低于對(duì)照組對(duì)應(yīng)節(jié)段的整體應(yīng)變值。2.各節(jié)段應(yīng)變值中,病例組左心室9/16節(jié)段的縱向應(yīng)變值(LS)減低,8/16節(jié)段的圓周應(yīng)變值(CS)減低,5/16節(jié)段的徑向應(yīng)變值(RS)減低,11/16節(jié)段的面積應(yīng)變值(AS)減低(p0.05);應(yīng)變值減低節(jié)段主要集中于前壁基底段、前壁中間段、前壁心尖段、前間隔基底段、前間隔中間段、后間隔基底段、后間隔中間段、后間隔心尖段。3.與對(duì)照組比較,左室整體旋轉(zhuǎn)角度、左室整體扭轉(zhuǎn)角度、左室整體扭力均低于正常對(duì)照組,差值有統(tǒng)計(jì)學(xué)意義。基底平面和心尖平面相應(yīng)節(jié)段的收縮期扭轉(zhuǎn)角度峰值、收縮期旋轉(zhuǎn)角度峰值、收縮期扭力都較正常組減低且差值有統(tǒng)計(jì)學(xué)意義。(P0.05)4.病例組GLS、GAS、GCS、GRS與LVEF呈正相相關(guān)關(guān)系(r=0.819,r=0.897,r=0.807,r=0.862,P0.0001)。5.病例組左室整體旋轉(zhuǎn)角度峰值、扭轉(zhuǎn)角度峰值、扭力峰值與LVEF呈正相相關(guān)關(guān)系(r=0.834,P0.0001;r=0.779,P0.0001;r=0.839,P0.0001)。結(jié)論:1.3D-STI能夠定量分析AMI患者PCI術(shù)后早期左心室整體心肌與局部心肌應(yīng)變值改變。2.3D-STI可以發(fā)現(xiàn)AMI患者PCI術(shù)后早期左心室旋轉(zhuǎn)、扭轉(zhuǎn)運(yùn)動(dòng)的變化,PCI術(shù)后早期病變心肌整體及局部心肌扭轉(zhuǎn)、旋轉(zhuǎn)值均下降。3.3D-STI參數(shù)中,左室整體應(yīng)變、左室整體旋轉(zhuǎn)角度、左室旋轉(zhuǎn)角度、左室整體扭力都與左室收縮功能具有良好的相關(guān)性,可以反映左室整體收縮功能。
[Abstract]:Objective: to evaluate the myocardial strain, global strain of left ventricle, rotation of left ventricle and torsion of left ventricle after percutaneous coronary intervention (PCI) in elderly patients with acute myocardial infarction (AMI) by using three dimensional speckle tracking imaging3D-STI technique. Left ventricular torsion and global left ventricular systolic function were used to elucidate the characteristics and clinical value of early myocardial strain, torsion and rotation parameters after PCI. Materials and methods: 30 patients with left anterior descending branch disease underwent PCI operation were included in the case group, and 30 healthy elderly patients were included in the control group. Three dimensional speckle tracing technique was used to detect myocardial motion and systolic function in two groups. Global longitudinal strains, global radial strains, global area strains, area strain values, peak systolic torsion angle of all segments of the left ventricular basal plane, left ventricle, left heart, left ventricle, left ventricle Peak apical twist-angle peak at each segment of the ventricular apex plane, left ventricular twist-LVtwa peak at the global left ventricular torsion angle, peak rotation angle peak value at each segment of the left ventricular basal plane and peak basal rotation at each segment of the left ventricular apical plane, rotation of each segment of the left ventricular apical plane Peak apical rotation, left ventricular rotation, peak basal torsion, peak apical torsion, left ventricular global torsion, left ventricular basal plane, peak basal torsion, peak apical torsion, left ventricular global torsion, left ventricular total torsion peak, left ventricular total torsion peak. Ventricular rotation, left ventricular ejection fractionation, left ventricular ejection fraction (LVEF), left ventricular ejection fraction (LVEF). The result is 1: 1. Compared with the control group, the whole strain value of the case group was lower than that of the corresponding segment of the control group. In the strain values of each segment, In the case group, the longitudinal strain value of the left ventricular segment of 9 / 16 segment was reduced, and the circumferential strain value of the segment of 8 / 16 segment was decreased. (CSS) the radial strain value of the segment of 5 / 16 segment was reduced and the area strain value of the segment of 11 / 16 segment was decreased by the area strain value of the segment of 11 / 16 segment. The decrease of the strain value segment was mainly concentrated in the anterior wall basal segment. Middle segment of anterior wall, apical segment of anterior wall, basal segment of anterior septum, middle segment of anterior septum, basal segment of posterior septum, middle segment of posterior septum, apical segment of posterior septum. Compared with the control group, the global rotation angle and the global torsion of the left ventricle were lower than those of the normal control group, and the difference was statistically significant. The peak of systolic torsion angle, peak systolic rotation angle and systolic torsion of the corresponding segment of basal plane and apical plane were lower than those of normal group, and the difference was statistically significant. There was a positive correlation between GRS and LVEF in the case group. In the case group, there was a positive correlation between the peak value of rotation angle and torsion of the left ventricle and the LVEF. There was a positive correlation between the peak value of rotation angle and the peak value of torsion in the left ventricle. There was a positive correlation between the peak value of torsion and LVEF. Conclusion the strain changes of whole and local myocardium of left ventricle in patients with AMI can be quantitatively analyzed by 1: 1.3D-STI. The early left ventricular rotation after PCI in AMI patients can be detected by 2.3 D-STI. The changes of torsion motion were correlated with the global and local myocardial torsion after PCI. In the parameters of 3.3D-STI, the global strain of the left ventricle, the rotation angle of the left ventricle, and the rotation angle of the left ventricle were decreased. The whole left ventricular torsion has good correlation with the left ventricular systolic function, which can reflect the left ventricular global systolic function.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R542.22

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