超声心动图对心肌梗死后患者左心室重构及其与心功能关系的研究

A echocardiographic study of the Left ventricle remodeling following infarction and its relationship to cardiac function in patients with myocardial infarction

目的 探讨超声心动图评价心肌梗死后左心室重构及其对心功能影响的价值。方法 应用多普勒超声测量 45例心肌梗死患者和 2 0例健康人对照组左心室大小、左心室收缩功能和舒张功能指标 ,并进行比较。结果 45例患者中 ,2 5例收缩功能异常 (EF=38.2 4± 9.43% ) ,其左心室增大及形态改变最明显 (L VDd 5 .94± 0 .95 cm )。另外 2 0例收缩功能正常 (EF=6 2 .0 0± 5 .96 % ) ,其左心室大小及形态无明显改变 (L VDd=5 .0 4± 0 .37cm)。两组比较差异显著 ,P<0 .0 0 1。两组心肌梗死患者均比正常对照组舒张功能 E峰减低、A峰增高、E/ A比值减小、DC减慢 P<0 .0 1。结论 心肌梗死后左心室重构与心功能变化密切相关。由左心室重构而引起的心脏扩大及球形改变 ,可进而影响心功能 。

Objective To evaluate the relatonship between Left venlricle(LV) remodeling following infarction and its cardiac function in patients with myocardial infarction (MI)using echocardiography. Method With Doppler ultrasonic apparatus, the size of LV, the indexes of its systolic and diastolic functions in 45 patients with MI and 20 healthy subjects were measured, and the results were analysed. Results Among 45 patients, of 25 cases LVEF was decreased, (38.24±9.43%), LV shape modified, and diamension dilated (LVDd 5.94±0.95cm). In other 20 cases LVEF was in normol range (62.00±5.96%), LV size and shape was not modified (LVDd 5.04±0.37cm). There was a significant difference (P< 0.001)between two groups. Comparing with the normal control group, in patients groups ,E peak decreased, A peak increased, E/A ratio dropped, and DC slowed down (P<0.001). Conclusion The LV remodeling following infarction in patients with MI is closely related to the cardiac function. The remodeling of LV can result in dilation and globular shape-change ,cardiac dysfunction and heat failure.