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目的应用二维超声斑点追踪技术(2D-STI)检测冠心病心肌应变和扭转改变与临床心功能分级进行比较,初步评价心肌应变及扭转定量判断冠心病临床心功能的价值。方法将56例冠心病患者分为临床心功能接近正常或正常组(30例)及心功能异常(26例),比较受检者临床心功能积分(NYHA-AP)、左室射血分数(LVEF)、左室心肌整体径向应变(GRS)、纵向应变(GLS)、左室心肌收缩期心肌扭转角度(TA)。结果两组比较:GLS、GRS、TA减低(P<0.05);心功能正常组GLS、GRS、TA与NYHA-AP及LVEF相关性不大,LVEF与NYHA-AP也相关性不大,而心功能异常组呈相关关系;以GLS-15.05%截断点判定患者心功能符合临床NYHA分级Ⅰ~Ⅱ级,灵敏度为88%、特异度为70%。结论 2D-STI技术检测心肌应变及扭转与临床心功能分级相关,有较好的灵敏度和特异度。
Objective To evaluate the clinical value of myocardial strain and torsion in quantitative assessment of clinical cardiac function by comparing the changes of myocardial strain and torsion in patients with coronary heart disease by 2D-STI. Methods Fifty-six patients with coronary heart disease were divided into three groups: clinical cardiac function close to normal or normal group (n = 30) and cardiac dysfunction (n = 26). The scores of NYHA-AP and left ventricular ejection fraction LVEF), left ventricular total radial strain (GRS), longitudinal strain (GLS), left ventricular systolic myocardial torsion angle (TA). Results There was no significant correlation between GLS, GRS, TA and NYHA-AP and LVEF, LVEF and NYHA-AP in the two groups were significantly lower than those in normal control group (P <0.05) The abnormal function group showed a correlation. According to GLS-15.05% cut-off point, the patients’ heart function was in accordance with clinical NYHA class Ⅰ ~ Ⅱ level, with a sensitivity of 88% and a specificity of 70%. Conclusion 2D-STI detection of myocardial strain and torsion correlated with clinical cardiac function classification, with good sensitivity and specificity.