二维应变技术对非ST段抬高型急性冠脉综合征危险分层的价值

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目的:探讨超声二维应变技术(2DSI)在非ST段抬高型急性冠状动脉综合征(NSTE-ACS)患者危险分层的价值。方法入选2012年1月至2013年3月在我院诊断为NSTE-ACS患者60例,依据GRACE危险积分作危险分层(高、中、低危组,n=20)。应用2DSI测量各组患者左室各心肌节段收缩期最大纵向应变(LS)、径向应变(RS)、圆周应变(CS)、心尖部扭转角度(RA)等,对最大应变值的均值进行组间比较,并与GRACE危险积分进行相关性分析。结果1. NSTE-ACS患者的左室收缩期LS、RS、CS峰值的均值均与GRACE危险积分呈负相关(r分别为-0.63、-0.72、-0.57,P<0.05),心尖部RA与GRACE危险积分无明显相关(P>0.05)。2.高危组患者左室收缩期LS、RS、CS均显著低于中、低危组(P<0.01)。结论2DSI能无创定量分析NSTE-ACS患者的左室心肌应变,部分应变峰值提示NSTE-ACS风险程度,2DSI对NSTE-ACS危险分层起重要的评价作用。“,”Objective To investigate the predicting value of two dimensional strain imaging (2DSI) on risk stratification in patients with non-ST elevation Acute coronary syndromes (NSTE-ACS). Methods 60 patients with non- ST elevation acute coronary syndrome were enrol ed in this study during Jan 2012 to March 2013. The GRACE risk score was used for risk assessment to divide the patients into 3 groups (high, mild and low risk groups). 2DSI was used to determine the left ventricle longitudinal strain (LS), radial strain (RS), circumferential strain (CS) rate curves and rotation angle (RA). Results 1.The patients’ LS, RS and CS were negatively associated with GRACE risk score (r for LS, RS and CS were -0.63、-0.72、-0.57 respectively,P<0.05), but no significant correlation was found between RA and GRACE risk score; 2. Compared with mild and low groups, high risk group were significantly decreased in these parameters as LS, RS and CS. Conclusion 2DSI is an effective manner in evaluating the risk stratification in patients with non-ST elevation acute coronary syndrome.
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