二维斑点追踪显像技术评价冠状动脉搭桥术对冠心病患者左室长轴收缩功能的影响

摘要

目的 应用二维斑点追踪显像(2D-STI)技术测量二尖瓣环运动评价冠心病(CHD)患者冠状动脉搭桥(CABG)治疗前后不同时期左室长轴收缩功能的改变.方法 分别于CABG术前、术后3～7 d、术后3个月及术后6个月应用STI技术测量EF＞50％的30例CHD患者左室长轴收缩功能指标的变化,并将30例正常人作为对照组.结果 与对照组比较,CHD患者CABG术前及术后SMD、SMV减低,差异均有统计学意义(P＜0.05),LVEF减低,差异无统计学意义(P＞0.05).CHD患者CABG术后3～7 d与CABG术前相比SMD、SMV减低,差异有统计学意义(P＜0.05),LVEF减低,差异无统计学意义(P＞0.05)；随着治疗时间的延长,SMD、SMV增高,差异有统计学意义(P＜0.05),LVEF有增高趋势,但差异无统计学意义(P＞0.05).结论 CABG对CHD患者左室长轴收缩功能有改善作用,且随再灌注时间的延长而改善明显,应用2D-STI测量二尖瓣环运动评价这一变化敏感且重复性良好.%Objective To evaluated the mitral annular movement by two-dimensional speckle tracking imaging (STI) in CHD patients,so as to assess the left ventfcular long axis systolic function with different periods before and after the treatment of coronary artery bypass graft.Methods The changes of left ventricular long axis systolic function in 30 CHD patients (EF＞50％ in CABG) were determined at different time points,including 3-7 days before and after treatment,3 months after treatment,6 months after treatment;another 30 normal subjects were recruited as controls.Results Compared with the normal controls,SMD,SMV was reduced in CABG preoperative and postoperative of CHD patients (P ＜ 0.05),LVEF was also lower than the normal (P ＞ 0.05).SMD,SMV was reduced after CABG treatment of 3-7 days compared with preoperative (P ＜ 0.05),LVEF was reduced,but the difference was not statistically significant (P ＞ 0.05).With the time of treatment,SMD,SMV was all elevated (P ＜ 0.05),LVEF was increased,but the difference was not significant (P ＞ 0.05).Conclusion CABG surgery improved the systolic function of left ventricular long axis form in CHD patients with prolonged reperfusion time;2D-STI measurements can be applied for the evaluation of mitral annular movement with a good sensitivity and repeatability.