心肌梗死不同时期患者心肌能量消耗变化及意义

Energy expenditure in myocardium of patients with myocardial infarction at different periods and its significance

目的探讨多普勒超声指标心肌能量消耗(MEE)在心肌梗死不同时期患者中的变化及临床意义。方法选取确诊为心肌梗死、且无心力衰竭的患者51例,按诊断分为急性心肌梗死(AMI)组28例,陈旧性心肌梗死(OMI)组23例;选取同期行冠状动脉造影正常的30例作为正常对照(NOR)组。采用多普勒超声技术检测,计算左心室收缩末周向室壁应力(cESS)及MEE;检测血浆N末端前体B型钠尿肽(NT-proBNP);并行相关性分析。结果与NOR组比较,AMI组和OMI组的cESS、MEE及lgNT-proBNP明显升高,且AMI组较OMI组升高更明显(P<0.05)。MEE与lgNT-proBNP呈正相关(r=0.605,P=0.0001),与左心室缩短分数和LVEF呈负相关(r=-0.393,-0.376,P=0.0001)。结论 MEE能有效地评估不同时期心肌梗患者的心功能状态。

Objective To study the energy expenditure in myocardium of patients with myocardial infarction at different periods and its clinical significance. Methods Fifty-five patients with myo- cardial infarction but without heart failure were divided into acute myocardial infarction （AMI） group （n=28） and old myocardial infarction （OMI） group （n=23）. Thirty patients with normal coronary angiography served as a normal control group. Their circumferential end-systolic wall stress （cESS） and energy expenditure in myocardium were detected by Doppler ultrasonography and their plasma NT-proBNP level was measured. Correlation of cESS and energy expenditure in myocardium with plasma NT-proBNP level was analyzed. Results The cESS,energy expenditure in myocardium and plasma NT-proBNP level were significantly higher in AMI group and OMI group than in normal control group and in AMI group than in OMI group （P（0.05）. The energy expenditure in myocardium was positively related with the plasma NT-proBNP level （r= 0. 605, P=0.0001） and negatively related with the LVFS and LVEF （r=- 0. 393,- 0. 376, P = 0. 0001）. Conclusion Energy expenditure in myocardium can effectively assess the heart function in patients with myocardial infarction at different periods.