急性心肌梗死后左室舒张功能的超声心动图评价

Evaluation of left ventricular diastolic function in patients with acute myocardial infarction by color Doppler echocardiography

目的应用彩色多普勒超声心动图对发生急性心肌梗死(AMI)的患者左室舒张功能进行观察。方法于心尖四腔切面检测舒张期二尖瓣血流频谱获得左室舒张早期最大流速(E)、左室舒张晚期最大流速(A)、E/A、E峰减速时间(DT)值;检测肺静脉血流频谱(PVFP)获得收缩期脉静脉血流频谱最大速度(S)、舒张早期脉静脉血流频谱最大速度(D)、S/D、舒张晚期肺静脉逆向血流的最大速度(Ar)值;测定主动脉瓣血流频谱结束到二尖瓣血流频谱开始之间的时间,即左室等容舒张时间(IRT),将病例组所测值与正常对照组进行比较。结果47例病例与46例正常对照组比较,病例组中有27例二尖瓣血流频谱E/A<1,DT,左室等容舒张时间(IRT)值增高,肺静脉血流频谱的S值显著增高,D值降低,S/D值显著增高;有13例二尖瓣血流频谱2≥E/A>1,肺静脉血流频谱S/D值显著降低,余各值差异无显著性;有7例二尖瓣血流频谱E/A>2,DT,IRT值减低,肺静脉血流频谱S值显著减低,S/D值显著减低。结论彩色多普勒超声心动图二尖瓣血流频谱及肺静脉血流频谱可以对AMI后左室舒张功能进行较准确的评价。

Objective To assess left ventricular diastolic function in patients with acute myocardial infarction（AMI） by Doppler echocardiography. Methods The mitral flow and pulmonary venous flow were detected by pulsed Doppler echocardiography in 47 patients and 46 control healthy persons on apical four chamber view. Results The DT and IRT of mitral flow in 27 patients were higher than those of control persons. Compared with control persons, the ratio E/A decreased.The S and S/D of pulmonary venous flow were higher than those of control persons but the D decreased. The ratios E/A of 13 patients were between land 2. There was no significant difference in other indexes. The ratio S/D significant decreased in pulmonary venous flow. There were 7 patients of whom the ratio E/A was beyond 2,however, the index of DT, IRT ,S and S/D were lower than control persons in mitral flow and pulmonary venous flow. The measurement of mitral flow and pulmonary venous flow is useful in assessing left ventricular diastolic function in patieras with acute myocardial infarction.