实时三维超声心动图评价心肌梗死患者左室局部心肌收缩功能的初步研究

Regional left ventricular systolic function evaluated by real-time three-dimensional echocardiography in patients with myocardial infarction

目的探讨实时三维超声心动图(RT-3DE)评价心肌梗死患者左室局部收缩功能的临床应用价值。方法24例正常人、8例前壁心肌梗死患者和9例下壁心肌梗死患者分别行心脏二维、三维超声心动图检查。应用Qlab定量分析软件对三维数据库进行定量评价,检测节段射血分数(REF)和节段-整体射血分数(R-GEF)。常规二维超声心动图检测收缩期室壁增厚率(△T%)。对受检者进行了重复测量,以评价该方法的重复性。结果与正常组相比,心肌梗死组部分节段REF和R-GEF明显减低(P<0.05)。两组心梗组间比较,部分节段的REF和R-GEF存在明显差异(P<0.05)。REF与△T%呈高度相关(r=0.76,P<0.01)。两次重复测量间无显著性差异(P>0.05),有显著相关性。结论实时三维超声心动图能够客观的定量评价心肌梗死患者左室局部收缩功能。

Objective To determine the use of real-time three-dimensional echocardiography（RT-3DE）in evaluation of the regional left ventricular systolic function in patients with myocardial infarction.Methods Two-dimensional echocardiography（2DE）,RT-3DE were performed in 24 normal subjects,8 patients with anterior myocardial infarction and 9 patients with inferior myocardial infarction.Seventeen segmental volume-time cures,regional ejection fractions（REF）and regional-global ejection fractions（R-GEF）were obtained by Qlab software.Percent systolic wall thickening（△T%）was measured in 2DE.Data for test-retest variability were obtained.Results Compared with normal subjects,patients＇ REF and R-GEF increased in the zones with infarction.REF and R-GEF of the two myocardial infarction groups had partly difference.REF had close correlation with △T%（r=0.76,P〈0.01）.Observer variability was acceptable,and repeatability of the method was excellent.Conclusion RT-3DE can objectively evaluate left ventricular regional systolic function in patients with myocardial infarction.