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目的探讨急性心肌梗死患者冠状动脉病变程度,对左室心肌扭转角度及心功能的影响。方法使用二维超声斑点追踪技术分别测量左室短轴切面心尖水平和瓣环水平各段心尖旋转角度峰值、心底旋转角度峰值、扭转角度峰值等指标,分析冠状动脉病变程度对扭转角度及心功能的影响,并测量左室内径及左室容积等参数。结果 (1)与对照组比较,心肌梗死各组各节段扭转角度、左室整体扭转角度及LVEF均下降(P<0.05)。(2)直线相关分析,心肌梗死组冠脉病变程度与LVEF有较好的相关性,r=0.816(P<0.05)。(3)ROC曲线显示,以左室整体扭转角度15.0°为临界值,预测心肌梗死病变累及双支曲线下面积为0.846,预测左室射血分数<45%的曲线下面积为0.738。结论急性心肌梗死患者随冠状动脉病变程度加重,左室心肌扭转角度和心功能明显下降。
Objective To investigate the degree of coronary artery lesion in patients with acute myocardial infarction and its effect on left ventricular myocardial torsion angle and cardiac function. Methods Two-dimensional ultrasound speckle tracking technique was used to measure the apical rotation angle, the rotation angle of the heart and the peak of torsion angle in the apex of left ventricular short axis view and the level of annulus respectively. The changes of coronary artery lesion on torsion angle and cardiac function Of left ventricular diameter and left ventricular volume and other parameters. Results (1) Compared with the control group, the torsion angle, the total left ventricular torsion angle and the LVEF of each segment of myocardial infarction group were decreased (P <0.05). (2) In the linear correlation analysis, the degree of coronary artery lesion in myocardial infarction group has a good correlation with LVEF, r = 0.816 (P <0.05). (3) The ROC curve showed that the area under the double-line curve of predicted myocardial infarction lesions was 0.846, and the predicted area under the curve of left ventricular ejection fraction <45% was 0.738, with the total left ventricular rotation angle of 15.0 ° as the critical value. Conclusion Patients with acute myocardial infarction with coronary artery disease worsened, left ventricular myocardial torsion angle and cardiac function decreased significantly.