世界中医药

目的：探讨速度向量成像技术（VVI）对择期PCI围手术期心肌损伤（PMI）的检测价值。方法：2015年3月至2015年11月共纳入76名成功接受PCI治疗的气虚血瘀证不稳定性心绞痛患者，根据术后是否发生PMI分为术后发生PMI组（n=16）和术后正常组(n=60)。对所有患者分别在术前和术后24 h进行传统超声心动和VVI检测，评估心室壁运动、心脏结构以及左室收缩功能情况。结果：2组VVI应变的动态变化中，发生PMI组患者术后24 h前壁、侧壁、下壁、后间隔、后壁、前间隔的心尖段以及侧壁和前间隔中间段的应变相较于术前发生了明显下降（P<0.05），术后正常组患者术前、术后应变均未见显著改变。2组VVI应变率的动态变化中，发生PMI组患者术后24 h前壁、下壁、后间隔、后壁、前间隔的心尖段以及前壁基底段的应变率相较于术前发生了明显下降（P<0.05），术后正常组患者术前、术后应变率均未见显著改变。传统超声检测方面，2组术前和术后24 h的相关参数均未见明显变化。结论：VVI相较于传统超声心动可能有助于PMI的早期发现，但相关研究仍需进一步深入。

English Summary:

To observe the clinical value of velocity vector imaging(VVI) on selective PCI of peri-procedure myocardial injury(PMI). Methods: A total of 76 unstable angina patients who had successfully received treatment of PCI and belonged to Qi deficiency and blood stasis syndrome were concluded in the study. The patients were divided into a group of patients suffering from PMI (n=16) and a normal group of patients without PMI (n=60). All patients received the examination of traditional Echocardiography and VVI at pre-PCI and 24 h post-PCI to evaluate the level of ventricular wall motion, cardiac structural and left ventricular systolic function. Results: In comparison of systolic strain, the levels of patients suffering from PMI had a significant decline from pre-PCI to 24 h post-PCI in the region of myocardial infarction(P<0.05), but there were no significant changes in normal group. In comparison of systolic strain rate, the levels of patients suffering from PMI had a significant decline from pre-PCI to 24 h post-PCI in the region of myocardial infarction(P<0.05), but there were no significant changes in normal group. In terms of traditional Echocardiography, none of the group had a significant change in related parameters from pre-PCI to 24 h post-PCI. Conclusion: VVI may have a contribution to early detection of PMI, but more studies are needed to verify it.

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