【摘要】 目的观察三维斑点追踪(3D-STI)技术联合冠状动脉SYNTAX评分(SS)评价复杂冠状动脉疾病(CAD)患者左心室心肌功能的价值。方法根据SS将78例CAD患者分为低分亚组(SS<23,n=26)、中分亚组(23≤SS<33,n=25)及高分亚组(SS≥33,n=27),应用3D-STI技术获取左心室整体纵向、径向、圆周、三维应变(GLS、GRS、GCS、G3DS)及各节段纵向、径向、圆周、三维应变(LS、RS、CS、3DS),计算平均基底段、中间段和心尖段LS、RS、CS、3DS,并进行组间比较。结果①低分、中分、高分亚组GLS、GRS、GCS和G3DS均呈减小趋势(P均<0.05),基底段LS、3DS,中间段和心尖段LS、RS、CS和3DS均呈减小趋势(P均<0.05);②ROC曲线分析示GLS、GCS、GRS和G3DS对不同程度CAD有一定检测价值,以G3DS及GLS的AUC最大;③复杂CAD患者GLS、GRS、GCS和G3DS与冠状动脉SS均呈负相关(r=-0.548、-0.366、-0.411、-0.556,P均<0.05);④重复性检验示3D-STI参数在观察者内及观察者间测量均有良好一致性。结论 3D-STI技术可在一定程度上反映复杂CAD患者冠状动脉病变程度,联合SS对于诊断CAD和指导治疗有一定意义。更多还原

【Abstract】 Objective To explore the value of three-dimensional speckle tracking imaging(3 D-STI)combined with coronary artery SYNTAX scores(SS)in evaluating the left ventricular function of patients with complex coronary artery disease(CAD).Methods Totally 78 patients with complex CAD were divided into low score subgroup(SS<23,n=26),medium score subgroup(23≤SS<33,n=25)and high score subgroup(SS≥33,n=27)according to SS.The global longitudinal strain(GLS),global circumferential strain(GCS),global radial strain(GRS),global three-dimensional strain(G3 DS)and longitudinal strain(LS),radial strain(RS),circumferential strain(CS)as well as three-dimensional strain(3 DS)of segments were obtained with 3 D-STI.Then LS,RS,CS,3 DS of basal segment,middle segment and apical segment were further calculated.The above indexes were compared among groups.Results(1)GLS,GRS,GCS and G3 DS all decreased in turn among low score,medium score and high score subgroups(all P<0.05).LS,3 DS of basal segment,LS,RS,CS and 3 DS of middle segment and apical segment also decreased gradually(all P<0.05).(2)ROC curve showed that GLS,GRS,GCS and G3 DS had a certain value in detecting degrees of complex CAD,and GLS and G3 DS had larger AUC.(3)GLS,GRS,GCS and G3 DS were negatively correlated with SS in the group of complex CAD(r=-0.548,-0.366,-0.411,-0.556,all P<0.05).(4)3 D-STI had good interobserver and intraobserver consistency.Conclusion 3 D-STI can reflect the complexity of coronary artery lesions,which has a certain guiding significance combined with SS in diagnosis and treatment of complex CAD.更多还原