多普勒组织成像速度图对心肌梗死的诊断价值探讨

The Value of Doppler Tissue Imaging Velocity Diagram in the Diagnosis of Myocardial Infarction

目的:探讨多普勒组织成像速度图对心肌梗死的诊断价值。方法:选取2018年1-12月本院收治的心肌梗死患者88例,根据体表心电图(ECG)定位诊断将其分为前壁梗死组(n=55)、下壁梗死组(n=33),另选取同期在本院进行体检的健康人群88例作为对照组。三组均进行多普勒组织成像速度图诊断。比较三组侧壁(lat)-心尖段(a)、lat-中间段(m)、lat-基底段(b)、室间隔(sept)-a、sept-m、sept-b、下壁(inf)-a、inf-m、inf-b、前壁(ant)-a、ant-m、ant-b收缩期峰值运动速度(Sm)与舒张早期峰值运动速度(Em)。比较三组左室壁内膜下心肌长轴Sm与Em情况。结果:前壁梗死组与下壁梗死组lat、sept、inf、ant各节段的Sm与Em均小于对照组(P<0.05)。前壁梗死组lat-a、lat-m、sept-m、sept-b的Sm均小于下壁梗死组,而lat-b、sept-a的Sm均大于下壁梗死组(P<0.05)。前壁梗死组lat-a、lat-m、lat-b、sept-a、sept-b的Em均小于下壁梗死组,而sept-m大于下壁梗死组(P<0.05)。前壁梗死组inf-m、inf-b、ant-a、ant-m、ant-b的Sm均小于下壁梗死组(P<0.05)。前壁梗死组inf-a、inf-b的Em均大于下壁梗死组,而ant-a、ant-m、ant-b的Em均小于下壁梗死组(P<0.05)。前壁梗死组与下壁梗死组前间隔(antsept)-b、antsept-m、后壁(post)-b、post-m的Sm与Em均小于对照组(P<0.05)。前壁梗死组antsept-b、antsept-m、post-m的Sm均小于下壁梗死组,而post-b的Sm大于下壁梗死组(P<0.05)。前壁梗死组antsept-b、post-m的Em均大于下壁梗死组(P<0.05)。结论:前壁与下壁梗死心肌各节段的运动速度均低于健康人,通过多普勒组织成像速度图可以对心肌运动异常情况检出,可以直观、准确地对患者的室壁异常运动情况进行反映,对心肌梗死具有诊断价值。

Objective:To explore the diagnostic value of Doppler tissue imaging velocity map for myocardial infarction.Method:A total of 88 patients with myocardial infarction admitted to our hospital from January to December 2018 were selected.They were divided into anterior wall infarction group (n=55) and inferior wall infarction group (n=33) based on the diagnosis of body surface electrocardiogram (ECG).Another 88 healthy people underwent physical examination in our hospital during the same period were selected as the control group.All three groups were diagnosed by Doppler tissue imaging velocity map.lat-a,lat-m,lat-b,sept-a,sept-m,sept-b,inf-a,inf-m,inf-b,ant-a,ant-m,ant-b peak systolic velocity (Sm) and early diastolic peak velocity (Em) among the three groups were compared.Sm and Em of left ventricular subintimal myocardial long axis among the three groups were compared.Result:The Sm and Em of the lat,sept,inf,and ant each segments in the anterior wall infarction group and inferior wall infarction group were lower than those in the control group (P<0.05).The Sm of lat-a,lat-m,sept-m,and sept-b in the anterior wall infarction group were lower than those of the inferior wall infarction group,while the Sm of lat-b and sept-a were higher than those of the inferior wall infarction group (P<0.05).The Em of lat-a,lat-m,lat-b,sept-a,and sept-b in the anterior wall infarction group were lower than those in the inferior wall infarction group,while sept-m was higher than that in the inferior wall infarction group (P<0.05).The Sm of inf-m,inf-b,ant-a,ant-m and ant-b in the anterior wall infarction group were lower than those in the inferior wall infarction group (P<0.05).The Em of inf-a and inf-b in the anterior wall infarction group were higher than those in the inferior wall infarction group,while the Em of ant-a,ant-m and ant-b were lower than those in the inferior wall infarction group (P<0.05).The Sm and Em of antsept-b,antsept-m,post-b and post-m in the anterior wall infarction group and the inferior wall infarction group were lower than those of the control group (P<0.05).The Sm of antsept-b,antsept-m,and post-m in the anterior wall infarction group were lower than those of the inferior wall infarction group,while the Sm of post-b was higher than that of the inferior wall infarction group (P<0.05).The Em of antsept-b and post-m in the anterior wall infarction group were higher than those in the inferior wall infarction group (P<0.05).Conclusion:The movement speed of each segment of the infarcted myocardium of the anterior wall and the inferior wall are lower than those of healthy people,the abnormal movement of the myocardium can be detected by Doppler tissue imaging velocity map,it can intuitively and accurately reflect the abnormal movement of the patient’s ventricular wall,which has diagnostic value for myocardial infarction.