【摘要】 目的 探讨应用二维斑点追踪(two-dimensional speckle tracking imaging, 2D-STI)技术评价不同节段心肌梗死患者左心室收缩功能的临床应用价值。方法 选择经冠状动脉造影证实的单支冠状动脉狭窄程度超过75.0%的急性心肌梗死(acute myocardial infarction, AMI)患者86例，采用超声心动图检测左心室常规收缩功能参数、应变参数及组织二尖瓣环位移(tissue mitral annular displacement, TMAD)参数，并与34例健康志愿者(对照组)比较。结果 (1)与对照组相比，前壁心肌梗死组(Ant-MI)、下壁心肌梗死组(Inf-MI)的左心室整体纵向峰值应变(global longitudinal systolic strain, GLS)、二尖瓣环收缩期峰值位移平均值(mean tissue mitral annular displacement, mTMAD)、瓣环连线中点最大位移平均值(tissue mitral annular displacement of the middle point, TMAD mid)、左心室长轴缩短率平均值(TMAD mid%)均减低，差异有统计学意义(P<0.05);(2)GLS的绝对值与左心室射血分数(left ventricular ejection fraction, LVEF)呈正相关(r=0.770,P<0.001);TMAD各参数与LVEF呈正相关(r=0.644、0.649、0.719,P<0.001);TMAD各参数与GLS的绝对值呈正相关(r=0.508、0.510、0.539,P<0.001);(3)TMAD参数中，TMAD mid%的AUC最大，AUC(TMAD mid%)=0.919,最佳截断值为10.90%,敏感度96.40%,特异度75.90%。结论 2D-STI技术可简便、准确评价不同节段心肌梗死患者的左心室收缩功能。更多还原

【Abstract】 Objective To discuss the clinical value of applying two-dimensional speckle tracking imaging(2D-STI)to evaluate left ventricular systolic function in patients with myocardial infarction of different segments. Methods A total of 86 patients with acute myocardial infarction(AMI)with single coronary artery stenosis over 75.0% confirmed by coronary angiography were selected. The parameters of left ventricular systolic function, strain and tissue mitral annular displacement(TMAD)were measured by echocardiography and compared with 34 healthy volunteers(control group). Results(1)Compared with the control group, global longitudinal systolic strain(GLS),and the mean value of tissue mitral annular displacement(mTMAD),tissue mitral annular displacement of the middle point(TMAD mid)and left ventricular longitudinal fractional shortening(TMAD mid%)decreased in anterior myocardial infarction groups(Ant-MI groups)and inferior myocardial infarction groups(Inf-MI groups). The difference was statistically significant(P<0.05);(2)the absolute value of GLS was positively correlated with left ventricular ejection fraction(LVEF)(r=0.770,P<0.001);TMAD parameters were positively correlated with LVEF(r=0.644,0.649,0.719,P<0.001);TMAD parameters were positively correlated with the absolute values of GLS(r=0.508,0.510,0.539,P<0.001);(3)among the TMAD parameters, TMAD mid% had the largest AUC(AUC(TMAD mid%)=0.919,the best cut-off value was 10.90%,the sensitivity was 96.40%,and the specificity was 75.90%. Conclusion 2D-STI technology can conveniently and accurately evaluate left ventricular systolic function in patients with myocardial infarction of different segments.更多还原