【作者】 李晶；

【导师】 任卫东；

【作者基本信息】 中国医科大学 ， 影像医学与核医学， 2010， 硕士

【摘要】 目的应用二维斑点追踪成像技术评价急性心肌梗死患者急诊经皮冠状动脉介入治疗术后左室短轴方向心肌节段不同形式运动的变化情况。了解急诊经皮冠状动脉介入治疗(PCI)对急性心肌梗死再灌注治疗的疗效。方法2008年12月至2009年4月入住我院接受急诊PCI治疗的急性心肌梗死患者32例,年龄(52.4±9.4)岁。除外陈旧性心肌梗死、糖尿病、严重瓣膜疾病、严重高血压性心脏病、先天性心脏病、严重心律失常及图像质量欠佳患者。应用二维斑点追踪成像技术于PCI术后一周和三个月分别获得心脏短轴圆周应变、径向应变、扭转角度。对所得数据进行统计学比较分析。结果1、PCI术后患者的射血分数、左心室舒张末期内径、左心室舒张末期容积、收缩末期容积、二尖瓣口E波峰值及E／A均低于对照组(P<0.05)。2、心肌梗死节段PCI术后一周圆周应变、径向应变及扭转角度较正常值明显减低(P<0.001)。心肌梗死节段PCI术后三个月圆周应变、径向应变及扭转角度较术后一周提高(P<0.05)。结论PCI可有效开通梗死相关动脉,提供持续的前向血流。随着心肌缺血的改善,局部和整体左室收缩功能逐渐恢复,表现为圆周应变、径向应变及扭转角度的增高。超声斑点追踪技术能够定量评价节段性室壁运动异常,为临床评价心肌梗死患者左心收缩功能提供无创性新方法。更多还原

【Abstract】 ObjectiveTo assess strain changes after percutaneous coronary intervention in patients with acute myocardial Infarction by left ventricular short axis two-dimensional speckle tracking imaging in different directions.To evaluate the effectt of emergency percutaneous coronary interventionon in patients with acute myocardial infarction.Methods30 cases of acute myocardial infarction with average age of 52.4±9.4 years old underwent emergency percutaneous coronary intervention between December,2008 and April,2009.Exclution previous myocardial infarction,diabetes mellitus(DM), Severe valve disease, severe hypertensive heart disease(HHD),congenital heart disease(CHD),severe arrhythmia and poor quality LV images.Circumferential strain, radial strain,rotation were evaluated with left ventricular short axis view speckle tracking imaging after PCI. Analyze the data with statistics method.Results1.Mean value of left ventricular ejection fraction,left ventricular end-diastolic diameter,left ventricular end-diastolic volume,left ventricular end-systolic volume, peak velocity of the early rapid filling wave after PCI were all lower than normal value, where there was remarkable difference(all of P<0.05).2.Mean value of circumferential strain,radial strain and rotation of 1 week after PCI were all lower than normal value,where there was remarkable difference(all of P<0.001).Mean value of circumferential strain,radial strain and rotation of 3 month after PCI were all higher than that of 1 week (all of P<0.05). ConclusionsPercutaneous coronary intervention can relieving infarction related artery,recover global andregional systolic function.Then radial strain,circumferential strain and rotation increased.Regional systolic function damaged because of myocardial ischemia in patients with acute myocardial infarction.Mean value of radial strain,circumferential strain and rotation were all degraded. Regional wall motion of left ventricule can be evaluated accurately and sensitively with two-dimensional speckle tracking imaging.更多还原