多巴酚丁胺负荷试验对急性心肌梗死后心电图ST段不同下降幅度患者的左心功能和存活心肌的评价

Evaluation on Left Ventricular Function and Viable Myocardium by Dobutamine Stress Echo in Patients with Acute Myocardial Infarction with Different Extent of ST Segments Elevation Resolution

目的 对AMI后心电图抬高ST段不同下降幅度患者的左心功能和存活心肌进行观察。方法 接受直接PTCA的AMI患者 5 0例 ,比较PTCA前后心电图ST段下降幅度并分为两组 ,A组 :ST段下降≥ 5 0 % ,B组 :ST段下降 <5 0 %。所有患者均行多巴酚丁胺试验。结果 A组EDVI、ESVI明显小于B组 (4 8 74vs 5 8 0 5 ,18 73vs2 5 76 ,P <0 0 5 ) ,LVEFA组明显高于B组 (6 3 49%vs 5 5 12 % ,P <0 0 5 )。基础及负荷状态GWMSI和IWMSIA组均明显小于B组 (1 16vs 1 32 ,2 11vs 2 47;1 0 6vs 1 2 2 ,1 39vs 1 98;P <0 0 5 )。无存活心肌者共 14例 ,A组8例 ,B组 6例 ,两组间无统计学差异。结论 AMI直接PTCA后ST段下降幅度≥ 5 0 %组的左心功能和室壁运动的恢复明显优于下降幅度 <5 0 %组。

Objective To evaluate left ventricular function and viable myocardium in patients with acute myocardial infarction (AMI) with different extent of ST segments elevation resolution. Methods Fifty patients with AMI who underwent direct percutaneous transluminal coronary angioplasty (PTCA) successfully were selected.All cases were underwent low\|dose dobutamine stress echocardiography at 7±2 days after AMI.The extent of the ST segments elevation resolution on electrocardiogram before and after direct PTCA were analysed.All patients were divided into two groups according to the extent of ST segments elevation resolution.Group A:ST segments elvation resolution≥50%( n =29);Group B:ST segments elevation resolution <50% ( n =21). Results Left ventricular end\|systolic\|volume index and end\|diastolic\|volume index of group A were significantly smaller than that of group B. Left ventricular ejection fraction of group A were higher than that of group B. Global wall motion score index and infarct\|zone wall motion score index of group A were smaller than that of group B. There were 14 patients without infarct\|zone viability, 8 patients in group A and 6 cases were in group B. There were no significant difference between the two groups. Conclution\ Group A has better left ventricular function and recovery of infarct\|zone wall motion than that of group B after AMI. [