斑点追踪成像技术在慢性心力衰竭药物疗效评价中的应用 点击下载
论文标题: 斑点追踪成像技术在慢性心力衰竭药物疗效评价中的应用
英文标题:
中文摘要: 目的:以琥珀酸美托洛尔缓释片为例,探索斑点追踪成像技术在慢性心力衰竭(CHF)药物疗效评价中的价值。方法:68例既往未接受正规治疗的CHF患者,均予以琥珀酸美托洛尔缓释片及常规抗心力衰竭药物治疗3个月。治疗前与治疗后1、3月分别记录患者纽约心脏病协会(NYHA)心功能分级、静息心率(RHR)、6 min步行距离(6MWD)及常规心脏超声测定值,存取心尖四腔心、两腔心及左室长轴切面动态图像进行斑点追踪脱机分析,测定左室整体纵向应变(LVGLS)。治疗3个月后,依据RHR将CHF患者分为达标组(A组,RHR为55~60次/min)与未达标组(B组,RHR>60次/min),比较两组患者上述各项指标治疗后的改善情况,同时比较LVGLS的改善情况。结果:组间比较,治疗1个月时A组较B组患者的RHR、左室舒张末前后径、左室射血分数(LVEF)、LVGLS显著改善,差异均有统计学意义(P<0.05);治疗3个月时,两组患者各项指标比较差异均有统计学意义(P<0.05)。A组组内比较,治疗1个月时RHR、6MWD、LVGLS显著改善,与治疗前比较差异有统计学意义(P<0.05);治疗3个月与治疗前及治疗1个月时比较,各项指标差异均有统计学意义(P<0.05)。B组组内比较,治疗1个月时RHR、6MWD有显著改善,与治疗前比较差异有统计学意义(P<0.05);治疗3个月与治疗前比较各项指标均有明显改善,差异有统计学意义(P<0.05),但与治疗1个月时比较,仅RHR与NYHA分级差异有统计学意义(P<0.05)。结论:斑点追踪成像技术可早期反映CHF患者抗心力衰竭治疗后心功能的改善情况,尤其是在RHR控制达标者中能更早更显著地反映。该技术同常规心功能评价指标一样,在随访抗心力衰竭疗效评价中具有良好的临床应用价值。
英文摘要: OBJECTIVE: Taking metoprolol succinate sustained-release tablets as an example, to explore the value of speckle tracking imaging in therapeutic efficacy evaluation of CHF drugs. METHODS: 68 CHF patients who had never underwent regular treatment were given Metoprolol succinate sustained-release tablets and anti-heart failure agents for 3 months. NYHA classification, resting heart rate (RHR), 6 min walk distance (6MWD) and conventional echocardiographic measurements were tested before and 1 and 3 months after treatment. Dynamic image were collected in the apical 2-chamber view, apical 4-chamber view and left ventricular long axis plane for speckle tracking imaging offline analysis. The left ventricular global longitudinal strain (LVGLS) were measured. After 3 months of treatment, CHF patients were divided into standard group (group A, RHR 55-60 times/min) and nonstandard group (group B, RHR>60 times/min) according to resting heart rate. The improvement of above indicators were compared between 2 groups, and that of LVGLS was also compared. RESULTS: After 1 month of treatment, RHR, LVEDd, LVEF and LVGLS of group A were improved significantly, compared with group B, with statistical significance (P<0.05). After 3 months of treatment, there was statistical significance in above indicators between 2 groups (P<0.05). In group A, RHR, 6MWD and LVGLS improved significantly after 1 month of treatment, there was statistical significance, compared with before treatment (P<0.05); there was statistical significance in above indicators after 3 months of treatment, compared with before treatment and after 1 month of treatment (P<0.05). In group B, RHR and 6MWD improved significantly after one month of treatment; there was statistical significance, compared with before treatment (P<0.05); there was statistical significance in significant improvement of each indicator between after 3 months of treatment and before treatment (P<0.05); only there were statistical significance in RHR and NYHA grading, compared with after one month of treatment (P<0.05). CONCLUSIONS: Speckle tracking imaging can early reflect the left ventricular function improvement of CHF patients after anti-heart failure treatment, especially in patients with RHR control standard earlier and more significant. Speckle tracking had good clinical application value in the follow-up treatment of heart failure as routine evaluation index.
期刊: 2016年第27卷第5期
作者: 廖康腊,张晓刚,秦俭,廖慧,刘莉
英文作者: LIAO Kangla,ZHANG Xiaogang,QIN Jian,LIAO Hui,LIU Li
关键字: 斑点追踪成像技术;琥珀酸美托洛尔缓释片;静息心率;慢性心力衰竭
KEYWORDS: Speckle tracking imaging; Metoprolol succinate sustained-release tablets; Resting heart rate; Chronic heart failure
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