核素心室显像对急性心肌梗塞远期预后的预测价值

PREDICTIVE VALUE OF EQUILIBRIUM RADIONUCLIDE VENTRICULOGRAPHY FOR LONG TERM PROGNOSIS OF ACUTE MYOCARDIAL INFARCTION

目的：探讨平衡法核素心室显像（ＥＲＮＶ）对急性心肌梗塞（ＡＭＩ）远期预后的预测价值。方法：对８９例于发病后４—６周行ＥＲＮＶ检查的ＡＭＩ患者进行了２３（１２—４２）个月的随访。参照病人预后，将其分为２组：第一组为出院后出现心脏猝死（ＳＣＤ）和（或）心力衰竭（ＮＦ）者（ｎ＝２０）；第二组为出院后无心脏事件者（ｎ＝６９）。并按年龄、性别进行１：２配对。对可能影响其远期预后的１７个参数进行了分析。结果：ＳＣＤ发生率为２．２％；去除年龄及性别因素，左室侧壁射血分数（ＬＡＴ－ＥＦ）、血清肌酸磷酸激酶同工酶（ＣＫ－ＭＢ）是判断ＡＭＩ远期预后的独立有效的危险因子；建立了一预后指数公式：Ｚ＝２．４７６（ＬＡＴ－ＥＦ）＋０．７６０（ＣＫ－ＭＢ），Ｚ越大，ＳＣＤ或ＨＦ发生率越高。结论：ＥＲＮＶ在ＡＭＩ远期预后的预测中有重要作用。

PURPOSE The predictive value of equilibrium radionuclide ventriculography(ERNV)for the long term prognosis of acute myocardial infarction(AMI)was studied.METHODS 89 patients witll AMI examined by ERNV 4- 6 weeks after onset of AMI were studied and followed up for 23(12-42)months.According to patients'prognosis,two groups were divided.Group 1 was patients with sudden cardiac death(SCD)or heart failure (HF)(n=20).Group 2,patients without any cardiac events(n=69).These patients were paired with the age and sex (ratio:1:2).17factors which may affect the long-term prognosis of AMI were analyzed. RESULTS 1.The incidence of SCD was 2.2%.2.Excluding the age and sex factor,the lateral wall ejection fraction of left ventricle(LAT-EF)and the level of serum CK-MB were two independent main effective risk factors of the long-term pmpnosis of AMI.3.Prognosis index formula:Z=2.467(LAT-EF)+0.760(CK-MB)was established. The larger the value of Z,the higher the incidence of SCD or HF.CONCLUSION ERNV played an important role on predicting long term Prognosis of patients with AMI.