目的 应用斑点追踪显像定量评价阻塞性睡眠呼吸暂停综合征患者的左心房功能,并进行对比研究。方法 OSAS患者60例,根据睡眠呼吸暂停低通气指数(AHI)分为3组,轻度组,中度组,重度组,每组20人;另选择20名健康正常人作为正常对照组。采用二维斑点追踪成像技术测量各组左心房相关应变参数:收缩期应变(Ss),舒张早期应变(Se),舒张晚期应变(Sa),左心房收缩期应变率(SRs),左心房舒张早期应变率(SRe),左心房舒张晚期应变率(SRa),分析并比较各组间参数的差异性。结果 随着疾病严重程度的增加Ss、SRs、Se、SRe呈逐渐减低的趋势,而Sa、SRa先升高后减低,差异有统计学意义(P<0.05)。结论 应用斑点追踪成像技术可在OSAS患者发生左心房重构前检测出心房功能的变化。

Objective The left atrial function of patients with obstructive sleep apnea syndrome was quantitatively evaluated by speckle tracing imaging and compared. Methods Sixty patients with OSAS were divided into three groups according to the sleep apnea hypopnea index(AHI),including the mild group, the moderate group and the severe group, with 20 patients in each group. Another 20 healthy people were selected as the normal control group. Left atrial correlation strain parameters:systolic strain(Ss), early diastolic strain(Se), late diastolic strain(Sa), left atrial systolic strain rate(SRs), early diastolic strain rate(SRe), left atrium left atrium late diastolic strain rate(SRa) were measured by two dimensional speckle tracking imaging technology, and the differences of parameters between groups were compared. Results With the increase of disease severity, Ss, SRs, Se and SRe showed a trend of gradual decrease, while Sa and SRa increased first and then decreased, and the difference was statistically significant(P<0.05). Conclusion Changes in atrial function may be detected in OSAS patients prior to left atrial remodeling using speckle tracking imaging.

目的 探讨应用三维斑点追踪技术(3D-STI)评价冠心病患者左前降支冠状动脉支架置入(PCI)术前、术后左室局部收缩功能。方法 对30例接受左前降支PCl术的患者分别于术前、术后3～5天,术后3个月进行常规及三维超声心动图检查,获得患者左前降支冠状动脉供血的7个心肌节段(即前壁基底段、前间隔基底段、前壁中间段、前间隔中间段、前壁心尖段、前间隔心尖段及心尖帽)的收缩期纵向应变、径向应变、圆周应变及面积应变,分析冠状动脉支架植入术前、后各参数的变化规律。结果 PCI术后3～5天5/7节段纵向应变(前壁基底段、前壁中间段、前间隔基底段、前间隔中间段、前壁心尖段)、3/7节段面积应变(前壁基底段、前壁中间段、前间隔中间段)、3/7节段圆周应变(前壁基底段、前间隔基底段、前壁中间段)及2/7节段径向应变(前间隔基底段、前壁中间段)较术前相应心肌节段升高,差异有统计学意义(P＜0.05),PCI术后3个月左前降支供血各心肌节段纵向、圆周、径向及面积应变较术前、术后3～5天均升高,差异有统计学意义(P＜0.05)。结论 3D-STI能够早期评价冠心病患者左前降支冠状动脉PCI治疗前后左室局部收缩功能的改善,为临床早期评价PCI疗效及后续治疗提供诊断依据。

Objective To evaluate the left ventricular regional systolic function before and after left anterior descending coronary artery stent implantation (PCI) using three-dimensional speckle tracking imaging (3D-STI) in patients with coronary artery disease. Methods 30 patients who received left anterior descending PCl were underwent routine and three-dimensional echocardiography before and after 3~5 days, 3 months to obtain longitudinal strain(LS), radial strain(RS), circumferential strain(CS)and area strain(AS) of the seven myocardial segments(BA,BAS,MA,MAS,AA,AS,A ),which accepted blood from the left anterior descending coronary artery. We analyzed the changes of the parameters before and after the coronary stent implantation. Results The 5/7 segment of the longitudinal strain(BA,MA,BAS,MAS,AA), 3/7 segment of area strain(BA,MA,MAS), 3/7 segment of circumferential strain (BA,BAS,MA)and 2/7 segment of radial strain (BAS,MAS)at 3~5 days after PCI were higher than that before the operation. The difference was statistically significant (P＜ 0.05). The longitudinal, circumferential, radial and area strain of the left anterior descending branch at 3 months after the operation were higher than that before and 3~5 days after the operation. The difference was statistically significant (P＜ 0.05). Conclusion 3D-STI may early evaluate the improvement of left ventricular regional systolic function before and after coronary artery PCI treatment in patients with coronary heart disease, and provide a basis for early clinical evaluation of PCI effect and follow-up treatment.