北京生物醫(yī)學工程

二維斑點追蹤技術評價冠心病患者心肌功能的研究

Evaluation of myocardial function in patients with coronary heart disease by speckle tracking imaging

作者：張麗華谷智明封淑文王巖

單位：                                            武警北京市總隊第二醫(yī)院特檢科（北京100037）                

關鍵詞：冠心病；室壁運動；縱向收縮期峰值應變；斑點追蹤技術；工作特征曲線

分類號：

出版年·卷·期（頁碼）：2015·34·5（505-508）

摘要：

目的應用二維斑點追蹤成像（speckle tracking imaging, STI）技術對常規(guī)方法顯示室壁運動正常的冠心病患者進行定量分析，探討STI技術用于診斷冠心病的臨床應用價值。方法采集經冠狀動脈造影證實的50例冠心病和40例對照組患者的心尖長軸、四腔和兩腔觀的二維灰階動態(tài)圖像，測量比較兩組各節(jié)段縱向收縮期峰值應變（global longitudinal systolic peak strain, GLPS）及整體縱向平均應變（GLPS-Avg），應用受試者工作特征曲線（receiver operating characteristic curve, ROC曲線）評價GLPS-Avg對篩選冠心病的敏感性和特異性。結果冠心病組各節(jié)段心肌的GLPS均明顯低于對照組，差異性具統(tǒng)計學意義（P＜0.05）。GLPS-Avg冠心病組(-15.79%±3.35%) 絕對值低于正常組(-19.02%±2.78%)的絕對值，有統(tǒng)計學差異（P<0.05）。ROC曲線顯示以GLPS-Avg-17.7%作為篩選冠心病的截斷值，其診斷敏感性為77.5%，特異性為60.0%，AUC=0.777。結論 STI作為早期診斷冠心病的指標是可行的。

Objective To investigate the clinical value of speckle tracking imaging (STI) in the diagnosis of coronary heart disease (CHD) with normal ventricular wall motion. Methods According to the results of coronary angiography, 50 patients with CHD and 40 age-matched subjects were enrolled. The two-dimensional loop-cines were obtained in apical 4-chamber view, apical 2-chamber view and long axis view of left ventricle. Globe longitudinal systolic peak strain (GLPS) and average globe longitudinal systolic peak strain (GLPS-Avg) were measured and calculated. GLPS-Avg were applied to evaluate the diagnostic efficiency for CHD by receiver operating characteristic curve. Results The absolute value of GLPS_Avg in CHD group (-15.79%±3.35%) was significantly decreased compared with that of the normal group (-19.02%±2.78%). The cutoff value of GLPS-Avg to diagnose CHD was-17.7%, with the sensitivity 77.5% and specificity 60.0%.Conclusions GLPS-Avg with STI technique was helpful to diagnose CHD.

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