超声观察老年急性心肌梗塞后的进行性左室重构

The observation of progressive left ventricular remodeling (PLVR)after myocardial infarction in the aged by echocardiography

目的观察老年急性心肌梗塞（ＡＭＩ）后进行性左室重构（ＰＬＶＲ）。方法４６例老年ＡＭＩ于入院时、出院前和ＡＭＩ后半年应用Ａｃｕｓｏｎ１２８或ＨＰ１５００型彩色多普勒超声检查。左室舒张末期容量指数（ＥＤＶＩ）每次增长＞８％者归为有ＡＭＩ后ＰＬＶＲ。结果９例有ＡＭＩ后ＰＬＶＲ者较３７例无ＡＭＩ后ＰＬＶＲ者心功能差（Ｐ＜０．０５）。在有ＡＭＩ后ＰＬＶＲ组ＡＭＩ并发症总例数较多（Ｐ＜０．０５）。结论老年人ＡＭＩ病例中心功能差者易发生ＡＭＩ后ＰＬＶＲ。ＡＭＩ并发症与ＡＭＩ后ＰＬＶＲ有关。

Objective Our study was to observe PLVR after acute myocardial infarction(AMI)in the aged. Methods PLVR after AMI was observed by color Doppler echocardiography(Acuson 128 or HP1500)in 46 aged patients.Each patient was examined firstly within one week after hospitalization,and then followed up twice,the day just before discharging from the hospital and half a year after AMI.If the enddiastolic volume index(EDVI)increased more than 8% each time,it suggested that PLVR occurred. Results 9 cases showed PLVR after AMI with decreased left ventricular function,where as the remaining 37 cases were rather normal (P<005).It appeared that the left ventricular function in the PLVR group seemed to be worse than that in the remaining group.At the same time,the complications of AMI appeared much more commonly in the PLVR group too. Conclusions PLVR would develop after AMI when the left ventricular function was worse in aged patients with AMI.The development of PLVR after AMI was related to the complications of AMI.