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目的探讨三维斑点追踪技术(3 dimensional speckle tracking,3DST)在诊断冠心病和评估冠状动脉狭窄程度方面的临床应用价值。方法选择2015年8月—2016年3月行冠状动脉造影,确诊为冠心病的患者43例,根据Gensini评分分成轻度病变组14例,中度病变组14例,重度病变组15例;选择冠状动脉造影阴性已排除冠心病,并排除心肌疾病、心脏瓣膜病者40例为对照组,采用三维斑点追踪技术评价各组临床指标及左心室整体收缩期应变均值、心肌节段的旋转及扭转角度,计量资料比较采用t检验,计数资料采用χ~2检验,采用Pearson法做相关性分析,以P<0.05为差异有统计学意义。结果对照组与冠心病组各项临床特征比较,重度病变组LVEDV、LVEF与对照组比较差异均有统计学意义(t=12.630、9.585,均P<0.05),重度病变组GCS、GRS、GLS评分较其他各组都有不同程度下降,随着冠状动脉病变加重,心肌旋转及扭转角度有下降趋势,患者左心室整体应变参数与冠状动脉Gensini评分之间的有相关性(r=0.722、0.495、0.674,均P<0.05),患者心肌旋转、扭转度数与冠状动脉Gensini评分之间的有相关性(r=0.578、0.409、0.603,均P<0.05)。结论三维斑点追踪技术在诊断冠心病和评价冠状动脉病变严重程度方面有一定价值。
Objective To investigate the clinical value of 3-dimensional speckle tracking (3DST) in the diagnosis of coronary artery disease (CAD) and in assessing the degree of coronary artery stenosis. Methods Forty-three patients diagnosed as coronary heart disease underwent coronary angiography from August 2015 to March 2016 were divided into mild lesion group (14 cases), moderate lesion group (14 cases) and severe lesion group (15 cases) according to Gensini score Coronary angiography had excluded coronary heart disease, and excluded myocardial disease, valvular heart disease in 40 cases as control group, using three-dimensional speckle tracking technology to evaluate the clinical indicators of each group and the average systolic left ventricular strain, myocardial segment rotation and torsion Angle, measurement data were compared using t test, count data using χ ~ 2 test, using Pearson correlation analysis, P <0.05 was considered statistically significant. Results There were significant differences in LVEDV and LVEF between severe group and control group (t = 12.630, 9.585, all P <0.05), GCS, GRS and GLS in severe group The score decreased compared with other groups. With the increase of coronary artery disease, the rotation and torsion angle of myocardium decreased. The overall left ventricular strain parameters were correlated with coronary Gensini score (r = 0.722,0.495 , 0.674, all P <0.05). There was a correlation between myocardial rotation and degree of coronary artery Gensini score (r = 0.578,0.409,0.603, all P <0.05). Conclusion Three-dimensional speckle tracking has some value in diagnosing coronary heart disease and evaluating the severity of coronary artery disease.