RT-3DE对于AMI患者左心室节段性收缩功能及左心室重构的评价

Real-time 3-dimensional echocardiography for reviewing left ventricular segmental systolic function and left ventricular remodeling in patients with acute myocardial infarction

目的探讨实时三维超声心动图(RT-3DE)评估急性心肌梗死(AMI)患者左心室节段性收缩功能及左心室重构中的应用价值。方法选取汉中市中心医院于2015年1月~2016年5月收治的30例AMI患者(AMI组)、30例健康对象(健康组),采用RT-3DE检查并测量并计算左室心肌质量(LVM)、左心室质量指数(LVMI)、左室舒张末期容积(LEDV)、左室收缩末期容积(LESV)、左室射血分数(LVEF)、左心室前壁和下壁各节段舒张末期容积(rEDV)、收缩末期容积(rESV)及各节段射血分数(rEF)等指标。结果 AMI组的LVM、LVMI、LEDV、LESV高于健康组,AMI组的EF低于健康组,差异有统计学意义(P均<0.05)。AMI组的的前壁基底段、前壁中间段、前壁心尖段、下壁中间段、下壁心尖段rEDV、rESV均显著的高于健康组,差异有统计学意义(P均<0.05)。AMI组的前壁基底段、前壁中间段、前壁心尖段、下壁基底段、下壁中间段、下壁心尖段rEF均显著的低于健康组,差异有统计学意义(P均<0.05)。结论 RT-3DE能评估AMI患者左心室重构及梗死心肌代偿节段的数目及范围。

Objective To discuss the application value of real-time3-dimensional echocardiography(RT-3DE)to left ventricular segmental systolic function and left ventricular remodeling in patients with acute myocardialinfarction(AMI).Methods AMI patients(n=30,AMI group)and health controls(n=30,health group)were chosenfrom the Central Hospital of Hanzhong City from Jan.2015to May2016.The indexes of left ventricular mass(LVM),left ventricular mass index(LVMI),left ventricular end-diastolic volume(LVEDV),left ventricular endsystolicvolume(LVESV),left ventricular ejection fraction(LVEF),end-diastolic volume(rEDV)and end-systolicvolume(rESV)of left ventricular anterior wall and inferior segments,and ejection fraction of segments(rEF)weredetected and calculated by using RT-3DE.Results The indexes of LVM,LVMI,LVEDV and LVESV werehigher,and LVEF was lower in AMI group than those in health group(all P<0.05).The indexes of rEDV and rESVof anterior basal segment,anterior middle segment,anterior apical segment,inferior middle segment and inferiorapical segment were significantly higher in AMI group than those in health group(all P<0.05).The indexes of rEFof anterior basal segment,anterior middle segment,anterior apical segment,inferior basal segment,inferior middlesegment and inferior apical segment were significantly lower in AMI group than those in health group(all P<0.05).Conclusion RT-3DE can be applied to review left ventricular remodeling and numbers of compensatory segmentsand range of infarction myocardium in AMI patients.