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目的探讨应用脉冲组织多普勒(PW-TDI)技术检测冠心病患者室壁节段性运动异常的应用价值。方法应用PW-TDI技术对61例冠心病患者(均经冠脉造影证实)和40例正常对照者左室壁节段各长轴切面进行检测,定量分析其运动速度、时相,并与冠造检查结果对照分析。结果在运动速度方面,冠脉轻度狭窄组e波和e/a明显低于正常对照组(P<0.01),中重度狭窄组e波和s波显著低于正常对照组(P<0.01),且低于轻度狭窄组(P<0.05),a波和R波明显低于正常对照组(P<0.05),e/a显著低于正常对照组(P<.01),却高于轻度狭窄组(P<0.05)。在运动时相方面,冠脉轻度狭窄组IVR波、IVC波和a波时相较正常组延长(P<0.05),e波、R波s波时相较正常组(P<0.05)。中重度狭窄组IVC波、IVR波时相较正常组显著延长(P<0.01),较轻度狭窄组延(P<0.05);s波、e波和R波时相较正常组明显缩短(P<0.01),比轻度狭窄组缩短(P<0.05)。结论PW-TDI是检测室壁运动异常的良好方法,定量检测、综合分析PW-TDI的运动速度指标和时相指标可准确地评价室壁节段性运动异常,对冠心病的无创诊断具有重要的应用价值。
Objective To investigate the value of pulsed tissue Doppler (PW-TDI) in the detection of segmental wall motion in patients with coronary heart disease. Methods Sixty-one coronary heart disease patients (all confirmed by coronary angiography) and 40 normal controls were examined by PW-TDI. The long axis of left ventricular segment was detected by PW-TDI, and its velocity and phase were quantitatively analyzed. Create inspection results of comparative analysis. Results In terms of exercise speed, the e wave and e / a in mild stenosis group were significantly lower than those in normal control group (P <0.01). The e wave and s wave in moderate and severe stenosis group were significantly lower than those in normal control group (P <0.01) (P <0.05), a wave and R wave were significantly lower than those in normal control group (P <0.05), e / a was significantly lower than that in normal control group (P <.01) Mild stenosis group (P <0.05). Compared with the normal group, IVR wave, IVC wave and a-wave phase in the mild coronary artery stenosis group were longer than those in the normal group (P <0.05). IVC wave and IVR wave length in moderate-severe stenosis group were significantly longer than those in normal group (P <0.01), and stenosis group (P <0.05). S wave, e wave and R wave phase were significantly shorter than those in normal group P <0.01), shorter than mild stenosis group (P <0.05). Conclusions PW-TDI is a good method to detect abnormal wall motion. Quantitative detection and comprehensive analysis of PW-TDI velocity and time phase indicators can accurately evaluate the segmental wall motion, which is important for noninvasive diagnosis of coronary heart disease The application value.