| 刘冬梅 武金玉△ 戴海鹏 戴全 赵天翀.RT-3DE 评估急性心梗PCI术后左室收缩功能及同步性的临床价值[J].,2017,17(7):1364-1367 |
| RT-3DE 评估急性心梗PCI术后左室收缩功能及同步性的临床价值 |
| Clinical Significance of RT-3DE for the Evaluation of Left VentricularSystolic Function and Synchronicity in Patients with Acute MyocardialInfarction after PCI |
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| DOI： |
| 中文关键词: 实时三维超声心动图 急性心肌梗死 左心室功能 同步性 |
| 英文关键词: Real-time three-dimensional echocardiography Acute myocardial Infarction Left ventricular function Synchronicity |
| 基金项目:黑龙江省卫生厅科研基金项目（2013260） |
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| 中文摘要: |
| 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。 |
| 英文摘要: |
| 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 |
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