AQ和CK评价静脉溶栓再灌注对急性心肌梗死患者左室早期重塑的影响

Evaluation on the Effect of Thrombolysis Recanalization on Early Left Ventricular Remodeling after Acute Myocardial Infarction with Acoustic Quantification and Color Kinesis

目的 :采用声学定量 ( acoustic quantification,AQ)和彩色室壁运动 ( color kinesis,CK)技术评价静脉溶栓再灌注对急性心肌梗死 ( AMI)患者左室早期重塑的影响。方法 :选择首次发病的Q波 AMI患者 ,将溶栓再通 1 3例作为研究组 ( 组 ) ,未溶栓治疗 1 5例作为对照组 ( 组 )。应用AQ和 CK技术分别在入院后 2 4 h内、1周和 4周时 ,对两组患者 AMI后左室容积和心功能的变化进行观察及对比研究。结果 :1不同时期溶栓再通组的 EDV、ESV明显小于未溶栓组 ;2入院后2 4 h内 ,两组患者的左室射血分数 ( EF)、峰值充盈率 ( PFR)及峰值排空率 ( PER)差异无显著性 ,而在 1周及 4周时溶栓再通组 EF、PFR和 EPR则明显高于入院后 2 4 h和对照组 ;3在入院后 2 4 h内 ,两组室壁运动指标比较差异无显著性 ,在第 1周和 4周时溶栓再通组室壁运动减弱和运动消失节段明显少于对照组。结论 :应用 AQ和 CK评价 AMI后左室功能和室壁运动的变化以及观察心肌缺血 -再灌注结果客观、准确 ,简便、省时、无创 ,患者易于接受。

Objective:To evaluate the effect of thrombolysis recanalization for the early left ventricular remodeling of acute myocardial infarction with acoustic quantification (AQ) and color kinesis (CK).Methods:The patients whose Q wave AMI came on for the first time were choosed,13 cases of reperfusion by thrombolysis were taken as the study group (Ⅰ),and 15 cases without the therapy as the control group (Ⅱ). The new ultrasonic technique-AQ and CK were applied on observing and studing comparatively the left venricular volume and heart function changes of AMI patients during the three periods (24 hours,the 1st week and 4th week) after hospitalization. Results: ① The data of EDV and ESV of the group Ⅰ were less that of than the group Ⅱ obviously during the 24 hours after hospitalization,as well as the 1st week and the 4th week. ② During the 24 hours after hospitalization, there was not marked differences between the two groups in the data: EF, PFR and PER,however,during the1st week and the 4th week, the three kinds of data of the group Ⅰ had risen obviously compared with the period within 24 hours, and more than that of the group Ⅱ. ③ During the 24 hours after hospitalization,the marker of Ventricular wall motion had no statistics differences ing the two groups. In the 1st and 4th week, the normal segment of the group Ⅰ was more than that of the group Ⅱ,but the weakness segment and the extinction segment of Ventricular wall motion were less than that of the group Ⅱ. Conclusion: Applying AQ and CK to evaluate the function of left ventricular and the changes of ventricular wall motion after AMI, and to observe the effects of myocardial ischemia reperfusion by thrombolysis a simple method that can save time,without wound and be accepted by patients.