多普勒组织成像在心肌梗死患者经皮冠状动脉介入术后的临床应用  

Application of Doppler Tissue Imaging in Assessment of Cardiac Function of Patients after Percutaneous Coronary Intervention for Myocardial Infarction: One Year Follow-up

作　　者：刘长福[1] 徐勇[1] 杨庭树[1] 

机构地区：[1]中国人民解放军总医院心血管内科,北京市100853

出　　处：《中国康复理论与实践》2007年第5期460-461,共2页Chinese Journal of Rehabilitation Theory and Practice

基　　金：军队"十五"医药卫生科研基金课题(01Z036)

摘　　要：目的研究多普勒组织成像(DTI)技术用于心肌梗死(MI)患者经皮冠状动脉介入术(PCI)术后心功能随访的可行性。方法选择86例MI住院患者,根据是否进行PCI术,分为PCI组45例和常规治疗组41例,术前、术后1个月、6个月、12个月行DTI及常规超声心动图检查。结果PCI术后,左室射血分数(EF)及应用DTI技术检测二尖瓣环四点(室间隔、侧壁、前壁、下壁)收缩期主峰S波速度的平均值术后1个月较术前即有明显改善,S波速度与EF之间的相关性较好,且比EF的敏感性更高。DTI二尖瓣环四点的舒张早期与晚期主峰速度e/a比值的平均值术后较术前增大;常规超声心动图二尖瓣口血流舒张早期与晚期主峰速度E/A比值无显著性差异。结论PCI术后,患者整体心脏收缩、舒张功能短期内得到改善;DTI技术观测AMI患者的心功能较常规超声心动图技术敏感性及特异性均高,可作为常规超声心动图的有力补充。Objective To evaluate the application of Doppler tissue imaging （DTI） in assessment of cardiac function after percutaneous coronary intervention （PCI） for myocardial infarction （MI） for long term follow-up. Methods 86 patients with MI were divided in PCI group （45 cases） and conventional therapy group （41 cases）. All the patients received two-dimensional echocardiography （2DE） and DTI measurements. The left ventricular ejection fraction （LVEF）, peak E, peak A wave velocities and peak E versus peak A （E/A） of 2DE were recorded, as well as the velocity of systolic wave（s） , early diastolic filling wave（e） , late filling wave（a） and wave e versus wave a （e/a） of DTI. Results The LVEF and the average velocity of systolic wave （s） of mitral annulus was increased after PCI （P〈0. 05）. S wave was related to LVEF, but the sensitivity of s wave is better than that of LVEF. There was no difference in the pulse Doppler trans mitral flow velocity E/A before and after PCI （P〉0.05） , but the average velocity of mitral annulus （e/a） was remarkably increased after PCI （P〈0.01）. Conclusion The left ventricular systolic and diastolic function in MI patients be improved after PCI. DTI is a sensitive method to detect the cardiac function after MI and PCI.

关 键 词：多普勒组织成像 超声心动图 心肌梗死 心功能 经皮冠状动脉介入术 

分 类 号：R541.4[医药卫生—心血管疾病]