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目的探讨二维斑点追踪显像(2DSTI)技术在评价陈旧性心肌梗死伴缺血性二尖瓣返流患者乳头肌功能中的临床价值。方法选取陈旧性心肌梗死伴缺血性二尖瓣返流患者78例(病例组)和健康体检者58例(对照组),应用2DSTI技术测量并比较两组左心室前外侧和后内侧乳头肌的收缩期峰值应变(APM-Ls和PPM-Ls)、运动速度(APM-Vs和PPM-Vs)和应变达峰时间(APM-Ts和PPM-Ts)。结果与对照组比较,病例组的APM-Ls和PPM-Ls较低[(-18.6±5.2)%vs.(-25.6±5.0)%和(-15.6±4.7)%vs.(-25.3±5.4)%](P<0.05),APM-Vs和PPM-Vs较慢[(2.9±1.1)cm/s vs.(4.9±1.2)cm/s和(2.6±1.0)cm/s vs.(5.2±1.4)cm/s](P<0.05),APM-Ts和PPM-Ts延长[(448.3±45.6)ms vs.(278.3±56.0)ms和(478.3±50.7)ms vs.(284.5±55.5)ms](P<0.05)。结论 2DSTI技术有助于评估陈旧性心肌梗死患者乳头肌的运动功能。
Objective To investigate the clinical value of two-dimensional speckle tracking imaging (2DSTI) in assessing papillary muscle function in patients with old myocardial infarction and ischemic mitral regurgitation. Methods 78 elderly patients with myocardial infarction with ischemic mitral regurgitation and 58 healthy controls were included in the study. The 2DSTI technique was used to measure and compare the left ventricular anterolateral and posterior medial papillary muscle (APM-Ls and PPM-Ls), exercise velocity (APM-Vs and PPM-Vs) and peak strain time (APM-Ts and PPM-Ts) were measured. Results Compared with the control group, APM-Ls and PPM-Ls were lower in the case group [(-18.6 ± 5.2)% vs (-25.6 ± 5.0)% and (-15.6 ± 4.7)% vs (2.9 ± 1.1) cm / s vs. (4.9 ± 1.2) cm / s and (2.6 ± 1.0) cm / s vs. (5.2 (448.3 ± 45.6) ms vs. (278.3 ± 56.0) ms and (478.3 ± 50.7) ms vs. (284.5 ± 55.5) ± (P <0.05) ms] (P <0.05). Conclusion 2DSTI technique can help evaluate the motor function of papillary muscles in patients with old myocardial infarction.