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目的 探讨实时三维斑点追踪成像(RT-3DSTI)技术评价冠状动脉狭窄患者左心室整体心肌应变的临床价值,以及整体应变与冠状动脉狭窄程度的相关性.方法 80例患者按冠状动脉造影结果分为:重度狭窄组34例,中度狭窄组28例,轻度狭窄组18例.30例健康志愿者作为对照.采用RT-3DSTI测量左室整体长轴应变(GLS)、整体径向应变(GRS)、整体圆周应变(GCS)、整体面积应变(GAS).应用ROC曲线分析整体应变参数诊断冠状动脉不同程度狭窄患者的临床价值.结果 重度狭窄组各应变参数均较其他三组减低,中度狭窄组GAS、GRS较轻度狭窄组及对照组减低,GLS较对照组减低(P＜0.05);ROC曲线表明各应变参数的曲线下面积(AUC)随着狭窄程度的加重而增加,其中GAS诊断重度狭窄的AUC最大,为0.926.结论 RT-3DSTI能较敏感地检测冠状动脉狭窄患者左心室心肌应变,其中GAS灵敏度最高.“,”Objective To evaluate real-time three-dimensional speckle-tracking imaging(RT-3DSTI) in detecting left ventricular myocardial strain in patients with coronary artery stenosis.Methods Eighty patients were divided into three groups according to the coronary artery angiography:34 cases in severe stenosis group,28 cases in moderate stenosis group and,18 cases in mild stenosis group.30 cases of healthy volunteers as control group.The global area strain (GAS),global circumferential strain (GCS),global longitudinal strain (GLS) and global radial strain (GRS) were analyzed by RT-3DSTI.The global strains to diagnose different coronary artery stenosis were analyzed by the receiver operating characteristic(ROC)curve.Results All parameters in the severe stenosis group were significant decreased compared with the other groups.GAS and GRS of moderate stenosis group were significant decreased than both mild stenosis group and control group(P＜0.05).ROC curve shows that along with the coronary stenosis increase,the area under the ROC curve(AUC)of each strain increase.The AUC of GAS to diagnose severe stenosis was0.926.Conclusions RT-3DSTI can assessment the left ventricular myocardial strain in patients with different graded coronary artery stenosis.Among them,Sensitivity of GAS is the highest.