【摘要】 目的:探讨实时三维超声心动图技术(realtime three dimensional echocardiography,RT-3DE)对评价急性心肌梗死(acute myocardial infarction,AMI)经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后左室收缩功能及同步性的临床应用价值。方法:选择30例左室急性前壁及前间壁心梗并进行急诊PCI术的患者和30例正常对照组,应用Philips IE33彩色多普勒超声成像仪对PCI术前及术后1个月的左心室功能指标进行二维常规超声检查及三维超声心动图检查,应用Q-lab6.0软件进行分析。结果:二维超声心动图显示AMI组术前左心室收缩末容量(ESV)及舒张末容量(EDV)较对照组比较明显增大(P<0.01),左心室射血分数(EF)较对照组明显减小(P<0.01);急性心肌梗死(AMI)组术后1个月左心室ESV及EDV较术前比较减小(P<0.05),左心室EF较术前增大(P<0.05);AMI组术后1个月左心室ESV及EDV较对照组比较增大(P<0.05),左心室EF较对照组减小(P<0.05);三维超声心动图的各参数比较,AMI组PCI术前梗死节段局部收缩末期容量(RESV)及局部舒张末期容量(REDV)较对照组增大(P<0.05),左心室梗死节段局部射血分数(REF)较对照组减小(P<0.05);AMI组患者梗死节段RESV及REDV术后1个月较术前比较减小(P<0.05),梗死节段REF较术前比较有所增大(P<0.05),AMI组术后1个月梗死节段RESV及REDV较对照组增大(P<0.05),梗死节段REF较对照组减小(P<0.05);左室16节段从QRS波起点到最小收缩容积时间的标准差和最大差值(Tmsvl6-SD、Tmsvl6-Dif)以及用R-R间期校正后的Tmsvl6-SD%(左室收缩不同步指数systolic dyssynchrony index,SDI)和Tmsvl6-Dif%较术前比较减小(p<0.05)。结论:PCI手术前、后应用RT-3DE能够准确评价左心室17节段的局部收缩功能及运动同步性,对AMI患者心功能的研究具有重要意义。更多还原

【Abstract】 Objective:To explore the clinical significance of RT-3DE in evaluating the left ventricular systolic function and synchronicity of patients with AMI after PCI therapy. Methods:30 patients performed emergency PCI treatment for Left ventricular anterior and anteroseptal myocardial infarction and 30 normal subjects as comparison were enrolled. Two-dimensional(2D) and Three-dimensiona(3D) echocardiography were performed for left ventricular function indicators before and one months after treatment respectively by using Philips IE33 ultrasonography. The left ventricular function indicators were quantitativly analyzed by the Qlab(6.0) software. Results:2D echocardiography displayed:the left ventricular end diastolic volume(LVEDV) and the left ventricular end systoli volume(LVESV)of AMI group were significantly increased and the left ventricle ejection fraction(LVEF) of AMI group was significantly reduced compared with those of control group before operation(P<0.01); the LVESV and LVEDV of AMI group reduced and the LVEF increased one month after operation compared with that of AMI group before operation(P<0.05; the LVESV and LVEDV of AMI group increased and the LVEF of AMI group reduced one month after operation compared with that of control group(P<0.05). 3D echocardiography displayed:the regional end-systolic volume(RESV) and the regional end-diastolic volume(REDV) of infarcted segments of AMI group increased and the regional ejection fraction(REF)of AMI group reduced compared with that of the control group before operation(P<0.05),the RESV and the REDV of infarcted segments of AMI group reduced and the REF of infarcted segments increased one month after operation compared with that of AMI group before operation(P<0.05), the RESV and the REDV of infarcted segments of AMI group increased and the REF of infarcted segments reduced one month after operation compared with that of control group(P<0.05). Conclusion:RT-3DE could accurately evaluate the left ventricular regional Systolic function and wall motion synchronism of 17 segments before and after PCI. RT-3DE could be a new valuable method to evaluate the cardiac function of patients with AMI更多还原