组织多普勒技术评估血栓抽吸治疗对急性下壁心肌梗死患者右室功能的影响

Evaluation of effects of thrombus aspiration on right ventricular function by tissue Doppler imaging in patients with acute inferior myocardial infarction

目的探讨组织多普勒(TDI)技术评估血栓抽吸治疗对急性下壁心肌梗死(AIMI)患者右室功能的影响。方法将46例AIMI患者随机分为两组,对照组27例行急诊经皮冠脉介入(PCI)治疗,观察组19例行PCI+血栓抽吸治疗。两组均于PCI后1周行超声心动图检查,在胸骨旁长轴用M型超声检测左室舒张末内径(LVEDD)、左房前后径(LAD)、右室舒张末内径(RVEDD)、左室射血分数(LVEF);在标准心尖四腔心切面转换为TDI频谱多普勒形式,检测三尖瓣环收缩期峰值运动速度(Sm)、舒张早期峰值运动速度(Em)、心房收缩期峰值运动速度(Am)及Em/Am比值;并计算右室Tei指数。结果与对照组比较,观察组三尖瓣环的Sm、Em、Am及Em/Am比值升高,右室Tei指数下降(P均<0.05),LVEDD、LAD、RVEDD、LVEF均无明显变化(P均>0.05)。结论 TDI技术能检测到AIMI患者的右室功能变化,血栓抽吸治疗可改善其右室功能。

Objective To evaluate the effects of thrombus aspiration therapy on right ventricular function by tissue Doppler imaging （ TDI ） in patients with acute inferior myocardial infarction （AIMI）. Methods Forty-six patients with AIMI were randomly divided into 2 groups： the control group （ n = 27 ） receiving percutaneous coronary intervention （ PCI）, and the observation group （n = 19 ） receiving PCI and thrombus aspiration together. Eehocardiography was taken in both groups 1 week later after PCI. From sternum long-axis views, the left ventricular end-diastolic dimension （LVEDD） , left atrial diameter （LAD）, right ventricular end-diastolic dimension （RVEDD） and left ventricular ejection fraction （LVEF） were observed by M-mode echocardiography. From the eehocardiographie apical 4-chamber views, the systolic peak velocity （Sm） , early diastolic peak velocity （Era） , atrial systolic peak velocity （Am） and the ratio of Era/Am of the tricuspid annulus were recorded by TDI; and the right vcntricular （RV） Tel index was calculated respectively. Results Compared with the control group, Sin, Em, Am and the ratio of Em/Am of the tricuspid annulus increased but the right ventrieular Tel index decreased （ all P 〈 0.05 ） in the observation group. No significant changes were found in LVEDD, LAD, RVEDD and LVEF （ all P 〉 0.05 ）. Conclusion TDI can detect the changes of RV function and thrombus aspira- tion therapy can improve RV function in patients with AIMI.