【摘要】 目的探讨组织多普勒(TDI)技术评估血栓抽吸治疗对急性下壁心肌梗死(AIMI)患者右室功能的影响。方法将46例AIMI患者随机分为两组,对照组27例行急诊经皮冠脉介入(PCI)治疗,观察组19例行PCI+血栓抽吸治疗。两组均于PCI后1周行超声心动图检查,在胸骨旁长轴用M型超声检测左室舒张末内径(LVEDD)、左房前后径(LAD)、右室舒张末内径(RVEDD)、左室射血分数(LVEF);在标准心尖四腔心切面转换为TDI频谱多普勒形式,检测三尖瓣环收缩期峰值运动速度(Sm)、舒张早期峰值运动速度(Em)、心房收缩期峰值运动速度(Am)及Em/Am比值;并计算右室Tei指数。结果与对照组比较,观察组三尖瓣环的Sm、Em、Am及Em/Am比值升高,右室Tei指数下降(P均<0.05),LVEDD、LAD、RVEDD、LVEF均无明显变化(P均>0.05)。结论 TDI技术能检测到AIMI患者的右室功能变化,血栓抽吸治疗可改善其右室功能。更多还原

【Abstract】 Objective To evaluate the effects of thrombus aspiration therapy on right ventricular function by tissue Doppler imaging( TDI) in patients with acute inferior myocardial infarction( AIMI). Methods Forty-six patients with AIMI were randomly divided into 2 groups: the control group( n = 27) receiving percutaneous coronary intervention( PCI),and the observation group( n =19) receiving PCI and thrombus aspiration together. Echocardiography was taken in both groups 1 week later after PCI. From sternum long-axis views,the left ventricular end-diastolic dimension( LVEDD),left atrial diameter( LAD),right ventricular end-diastolic dimension( RVEDD) and left ventricular ejection fraction( LVEF) were observed by M-mode echocardiography. From the echocardiographic apical 4-chamber views,the systolic peak velocity( Sm),early diastolic peak velocity( Em),atrial systolic peak velocity( Am) and the ratio of Em / Am of the tricuspid annulus were recorded by TDI; and the right ventricular( RV) Tei index was calculated respectively. Results Compared with the control group,Sm,Em,Am and the ratio of Em / Am of the tricuspid annulus increased but the right ventricular Tei index decreased( all P < 0. 05) in the observation group. No significant changes were found in LVEDD,LAD,RVEDD and LVEF( all P > 0. 05). Conclusion TDI can detect the changes of RV function and thrombus aspiration therapy can improve RV function in patients with AIMI.更多还原