平衡法门控心血池显像评价不同分级前壁心肌梗死患者左室收缩及舒张功能

Parameter assessment of left ventricular systolic and diastolic function in patients with different-class anterior myocardial infarction by radionuclide ventriculography

目的 我们应用平衡法门控心血池显像技术对不同Killip分级的前壁心肌梗死患者进行左室总体和局部收缩和舒张功能参数的对比分析。方法 对照组15例（G0），前壁心肌梗死KillipⅠ级17例（G1），前壁心肌梗死KillipⅡ-Ⅲ级12例（G2）。利用平衡法门控心血池显像技术评价3组的左室总体和局部的收缩与舒张功能。结果 ①左室整体收缩功能，在LVEF，ESC2个参数中，G1比G0有显著差异（P〈0．05），G2分别比G1和G0有显著差异（P〈0．05）。在PER、1／3EF、1／3ER3个参数中，G2分别比G1和G0显著下降（P〈0．05）。②左室总体舒张功能，在PFR、1／3FF、1／3FR、EDC中，G1比G0有显著差异（P〈0．05），G2分别比G1和G0有显著差异（P〈0．05）。③左室局部收缩功能，在以LVREF为参数时，G1在4个节段比G0显著差异（P〈0．05），G2在所有6个节段中比G1和G0均显著下降（P〈0．05）。④左室局部舒张功能，在以LVR1／3FF为参数时，G1在4个节段比G0显著下降（P〈0．05），G2在所有6个节段比G0和G1均显著下降（P〈0．05）。结论 前壁心肌梗死后出现心功能受损或心力衰竭的主要原因为左室重构。

AIM To assess the parameters of global and regional left ventricular systolic and diastolic function in patients with different-Killip-class anterior myocardial infarction by the technology of radionuclide ventriculography. METHODS A control group of 15 cases （ Go）, 17 cases with Killip-I-class an- terior myocardial infarction （G1 ） and 12 cases with Killip-Ⅱ-and -Ⅲ-class anterior myocardial infarction （ G2 ） were included in the study and the parameters of global and regional left ventricular systolic and diastolic functions were assessed in the three groups. RESULTS ①For left ventricular global systolic function, the two parameters of LVEF and ESC in G1 were significantly different compared with that in Go （P 〈 0.05 ）, and the parameters in G2 were significantly different compared with those in G1 and Go respectively （P 〈0.05 ）. The three parameters of PER 1/3EF and 1/3ER in G2 were significantly different compared with those in G1 and GO respectively （P 〈0.05 ）.②For left ventricular global diastolic function, the four parameters of PFR, 1/3FF, 1/3FR and EDS in G1 were significantly different compared with those in Go（ P 〈0.05 ） and the parameters in G2 were significantly different compared with those in G1 and Go respectively （ P 〈 0.05 ） ③For left ventricular regional systolic function, the parameters of LVREF in G1 were reduced significantly in four segments compared with those in Go （ P 〈 0.05 ） and the parameters of LVREF in G2 were significantly reduced in all the six segments compared with those in G1 and G0 respectively （P 〈 0.05 ）.④For left ventricular regional diastolic function, the parameters of LVR1/3FF in G1 were significantly reduced in four segments compared with those in Go （P 〈 0.05 ） and the parameters of LVR1/3FF in G2 were significantly reduced in all the six segments compared with those in G1 and Go respectively （P 〈 0.05 ）. CONCLUSION The factors for heart failure after anterior myocardial infarction include left ventricular remodeling, decrease of left ventricular systolic function and left ventricular diastolic dysfunction.