多巴酚丁胺试验对急性心肌梗死心电图ST段不同下降幅度患者左室收缩及储备功能的评价

Evaluation on Left Ventricular Contractile Function and Reserve Function by Dobutamine Stress Echocardiography in Patients Having Different ST Segments Elevation Resolution with Acute Myocardial Infarction

目的 :评价急性心肌梗死后心电图抬高ST段不同下降幅度患者的左室收缩功能及收缩储备功能。材料和方法 :接受直接PTCA的AMI患者共 42例 ,于入院后第 7± 2天行多巴酚丁胺负荷超声心动图。以PTCA前及后 1小时 12导联心电图抬高ST段的下降幅度分为两组 ,A组 :ST段下降≥ 5 0 %共 2 3例 ,B组 :ST段下降 <5 0 %共 19例。结果 :基础状态 ,左室射血分数A组明显高于B组 (6 2 98% ,5 7 2 1% )。主动脉峰值流速、峰值加速度、血流速度积分、每搏输出量、每搏指数A组与B组间无统计学差异。用药 10ug/kg·min-1后主动脉峰值加速度、每搏输出量及每搏指数A组明显高于B组 (3 6 2vs 2 45 ;12 7 30vs 10 2 75 ;77 87vs6 0 2 9)。结论 :心电图ST段下降幅度≥ 5 0 %组的左室收缩功能及收缩储备功能明显好于ST段下降幅度 <5 0 %组。

Purpose: To evaluate left ventricular contractile function and contractile reserve function in patients having different ST segments elevation resolution with acute myocardial infarction. Materials and Methods: 42 patients with a first AMI successfully treated with direct coronary angioplasty underwent low dose dobutamine stress echocardiography at 7±2 days after AMI. The extent of the ST segments elevation resolution on electrocardiogram on admission and one hour after direct PTCA were analyzed. All patients were divided into two groups according to the extent of ST segments elevation resolution. Group A: ST segments elevation resolution ≥50%; Group B: ST segments elevation resolution <50%. Results: At baseline, left ventricular ejection fraction (LVEF) in group A were higher than that in group B. AOPK, ACC, CV, CVI and SVI were not different between group A and group B. ACC, CV and CVI were significantly higher in group A than in group B by using dobutamine at dosage of 10ug/Kg/min. Conclusions: Group A has better left ventricular contractile function and contractile reserve function than group B.