实时三维超声评价心肌梗死患者介入术后心脏整体及局部收缩功能

Real-time three dimensional echocardiography for evaluating overall and local cardiac contraction function after interventional operation in patients with myocardial infarction

目的探讨应用实时三维超声评价心肌梗死患者经介入术后心脏整体和局部收缩功能的参考意义。方法选择该院2014年5月至2015年4月期间经介入术治疗的心肌梗死患者共48例,作为患者组,分别于术后1周和术后1个月应用实时三维超声进行检查,经软件分析得到左心室整体以及左心室前壁中间段、前间壁中间段、心尖帽等局部的容积-时间曲线,对其收缩功能进行评价,同时选取同期健康人50例作为对照。结果在患者组患者以及健康人的比较中得出,两组分别进行双平面Simpson法与RT-3DE法对比得到,患者组左心室舒张末期容积(LVEDV),左心室收缩末期容积(LVESV)值均高于对照组;患者组左室射血分数(LVEF)值明显低于对照组低;两项比较差异有统计学意义(P<0.05)。患者心脏整体及局部收缩功能结果显示,术后1个月相比于术后1周,舒张末期容积、收缩末期容积以及收缩不同步指数值明显降低,而节段射血分数值明显升高,组间结果比较差异有统计学意义(P<0.05)。结论应用实时三维超声可以定量评价心肌梗死患者经介入术治疗后的心脏整体以及局部收缩功能,值得推广。

Objective To use the real time three dimensional echocardiography to evaluate the overall and local cardiac contrac‐tion function after interventional operation in the patients with myocardial infarction .Methods Forty‐eight cases of myocardial in‐farction treated by interventional operation in our hospital from May 2014 to April 2015 were selected as the myocardial infarction group and performed the real time three dimensional echocardiographic examination at postoperative 1 week and postoperative 1 month respectively .The local volume‐time curves of the overall left ventricle ,middle section of left ventricle anterior wall ,antero‐septal middle section and cardiac apex were obtained by using the software analysis .Their contraction function was evaluated ,mean‐while contemporaneous 50 healthy persons were selected as the controls .Results The results were obtained from the comparison between the cardiac infarction group and the healthy persons ,which in the two groups were obtained by the comparison between the biplane Simpson method and RT‐3DE method .The LVEDV and LVESV values in the cardiac infarction group were higher than those in the control group ;the LVEF value in the cardiac infarction group was significantly lower than that in the normal control group ,the differences were statistically significant（P 〈 0 .05） .The heart overall and local systolic function of the patients showed that the end‐diastolic volume ,end‐systolic volume and systolic dyssynchrony index in the group B were significantly decreased com‐pared with the group ,while the segmental ejection fraction value was significantly increased ,the difference between the two groups had statistical significance （P〈 0 .05） .Conclusion Applying the real‐time three‐dimensional ultrasound can quantitatively evaluate the overall and local cardiac contraction function after interventional operation therapy in the patients with myocardial infarction and is worthy of promotion .