急性心肌梗塞早期左心室容积参数与收缩功能关系的研究

The Relationship between Indices of Left Ventricle Volumes and Left Ventricular Ejection Fraction in Early Acute Myocardial Infarction

目的 :研究急性心肌梗塞早期左心室收缩末容积、左心室舒张末容积、每搏搏出量及左心室射血分数改变特点及其相互关系和意义。 方法 :首次急性心肌梗塞患者 37例为患者全组 ,平均年龄 6 1.2± 10 .0岁 ,平均发病时间 6 .6± 5 .8小时 ,其中前壁组 2 2例 ,下壁组 15例 ,另设正常对照组 11例。采用双探头门控单光子发射计算机断层摄影系统采集心肌显像资料 ,由计算机内已设程序自动计算左心室射血分数及各容积参数。 结果 :1左心室舒张末容积 :患者全组为 110 .0± 45 .2 ml,其中前壁组和下壁组分别为 12 5 .4± 43.9ml和 87.9±38.3ml,正常对照组为 74.7± 12 .2 ml,患者全组与正常对照组、下壁组和前壁组间均差异显著 (P<0 .0 5 )。 2左心室收缩末容积 :正常对照组 ,患者全组 ,前壁组和下壁组分别为 2 5 .3± 5 .8ml,6 4.0± 35 .9ml,79.0± 33.7ml和 42 .0±2 7.3ml。正常对照组与患者全组之间差异十分显著 (P<0 .0 0 1) ,前壁组与下壁组之间差异显著 (P<0 .0 1)。 3每搏搏出量 :正常对照组 ,患者全组 ,前壁组和下壁组四者两两之间均无差异。 4左心室射血分数 :患者全组显著低于正常对照组(0 .6 6± 0 .0 5比 0 .45± 0 .13,P<0 .0 0 1) ,前壁组低于下壁组 (0 .38± 0 .0 8比 0 .5 5± 0 .11。

Objective:To assess left ventricular ejection fraction(LVEF) and its relationship with left ventricular end diastolic volume (LVEDV),left ventricular end systolic volume (LVESV) and stroke volume (SV) of left ventricle in early acute myocardial infarction(AMI) by gated single photon emisson computed tomography (GSPECT) Methods:Thirty seven patients with pts early first acute myocardial infarction underwent GSPECT with 99m Tc methoxy isobutylison itrile(MIBI).The LVEDV,LVESV and LVEF were calculated by the GSPECT system automatically.The time from chest pain to admission was 6 6±5 8 hours.The pts were divided into anterior infarction subgroup(22 pts) and inferior infarction subgroup (15 pts).The average age was 61 2±10 0 years old. Results:The LVEDV for 37 pts,anterior subgroup,inferior subgroup and normal controls were 110 0±45 2ml,125 4±43 9ml,87 9±38 3ml and 74 7±12 2ml,respectively.LVEDV in all pts.was larger than normal controls ( p <0 05) and that in inferior infarction was larger than in anterior infarction.LVESV for 37 pts,anterior subgroup,inferior subgroup and normal controls were 25 3±5 8ml,64 0±35 9ml,79 0±33 7ml and 42 0±27 3ml,respectively.LVESV in all pts was larger than in normal controls ( p <0 001),and that in inferior infarction was larger than in anterior infarction ( p <0 01).SV in controls,all pts,anterior infarction and inferior infarction there was no significant difference between them.LVEF in all pts (0 45±0 13) was lower than that in controls (0 66±0 05), p <0 001,and that in anterior infarction (0 38±0 08) was lower than in inferior infarction (0 55±0 11), p <0 001.LVEDV was correlated with LVESV and SV in all pts,anterior infarction and inferior infarction significantly ( p <0 001).LVEF was correlated with LVEDV and LVESV negatively( p <0 001).There was no clear relationship between LVEF and SV. Conclusion:Remodeling of the left ventricle appeared early after acute myocardial infarction.LVEDV and LVESV increased and LVEF decreased significantly.SV remained at nearly normal level.There was no relationship between LVEF and SV.The results suggest that when LVEF is evaluated,attention should be paid to LVEDV,LVESV and SV simultaneously.