左心室壁收缩后收缩在正常、缺血和梗死心肌中的分布及特征  

Distribution and characteristic of left ventricular post-systolic shortening in normal, ischemic and infarcted myocardium

作　　者：阮雯[1] 舒先红[1] 潘翠珍[1] 刘诗珍[1] 黄国倩[1] 董丽莉[1] 陈灏珠[1] 

机构地区：[1]复旦大学附属中山医院心血管病研究所心超室,上海200032

出　　处：《中华超声影像学杂志》2007年第5期377-381,共5页Chinese Journal of Ultrasonography

摘　　要：目的 运用组织速度显像（TVI）评价左室收缩后收缩（PSS）在正常人和心肌梗死患者中的分布及意义。方法 入选45例心肌梗死患者，包括急性下壁心肌梗死（B组）、急性前壁心肌梗死（C组）、陈旧性前壁心肌梗死（D组）各15例，正常对照组（A组）15例。在组织多普勒显像模式下测量左室长轴16节段的收缩、舒张及PSS峰值速度、收缩达峰时间、收缩期位移和应变，在二维超声下测量左室射血分数、舒张末及收缩末容积。结果 ①正常人PSS约占19％，心肌梗死后其比例升高2～4倍，升高幅度从高到低依次为C组〉D组〉B组（P〈0．01），且梗死和缺血区〉正常区（P〈0．01）；②正常人PSS与收缩期期峰值速度的比值为0．66±0．65，心肌梗死后其比值升高且以C、D组升高最明显（P〈0．01）；③B组除PSS、舒张早期和晚期峰值速度外（P〈0．05），其余节段功能指标在梗死、缺血和正常区之间差别无统计学意义（P〉0．05）；④各组左室射血分数值与PSS峰值速度的相关性差异无统计学意义（P〉0．05）；⑤D组PSS比例与其舒张末及收缩末容积呈正比（P〈0．05）。结论 用TVI技术评价左室壁的PSS可以敏感识别心肌节段功能的细微变化，是具有临床应用潜力的新指标。Objective Using tissue velocity imaging （TVI） to evaluate incidence and clinical significance of post-systolic shortening（PSS） among normal,acute and old myocardial infarction （AMI and OMI） patients. Methods Forty five patients were evenly divided into inferior AMI group （group B）, anterior AMI group（group C） ,and anterior OMI group（group D） ,with a control group of 15 patients（group A）. Peak velocity of PSS（Vps）,systolic velocity （Sm）,early and late diastolic velocity （Em, Am）, time to peak velocity （TTP）, systolic displacement （Dsys） and systolic strain （Ssys）, left ventricular ejection fraction （LVEF） ,end-diastolic volume（EDV） and end-systolic volume（ESV） were measured on the 16 segments of longitudinal left ventricular wall. Results ①Percentage of PSS was about 19% in the normal group. After MI, it was significantly increased, and the increase was greatest in group C, then in group D, and smallest in group B（ P 〈0.01 ）,and the increase was also greater in the infarct and ischemic regions than that in nonischemic regions（ P 〈0.01 ）.②Vps/Sm ratio was 0. 66 ± 0. 65 in group A. After MI it raised,most evident increase was shown in group C and D （ P 〈0.01 ）. ③There were no significant differences in all the other tissue Doppler parameters among the normal, ischemic and infarction regions in group B except for Vps, Em and Am （ P〈0.01）. ④The correlation between Vps and LVEF was not significant in any of the four groups （ P〉0. 05）. ⑤ Percentage of PSS showed clear positive correlation with EDV and ESV in group D （ P〈0.05）. Conclusions PSS measured by TVI could be a promising non-invasive parameter to evaluate subtle change of left ventricular segmental function.

关 键 词：超声心动描记术 多普勒 心肌梗塞 心室功能 左 

分 类 号：R686[医药卫生—骨科学]