PWDTI对急性心肌梗死不同方案治疗后局部室壁运动的评估  

Evaluation of the regional wall motion change after different treatments on acute myocardial infarction by pulsed-wave tissue doppler imaging

作　　者：蔡伟[1] 周长钰[1] 蔡金荣[1] 郑成环[1] 叶岚[1] 

机构地区：[1]天津医科大学第二医院,天津300211

出　　处：《中国心血管杂志》2007年第3期172-174,共3页Chinese Journal of Cardiovascular Medicine

基　　金：天津市高等学校科技发展基金(20020225)

摘　　要：目的应用脉冲组织多普勒成像技术(pulse-wave doppler yissue imaging,PWDTI)评价急性心肌梗死(acute myocardial infarction,AMI)不同治疗方案后局部室壁功能的变化情况。方法 AMI 患者72例,分为3组,经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)组30例,溶栓组27例,保守治疗组15例。采用PWDTI 定量测定患者治疗一周时局部室壁运动速度同时结合常规16节段超声心动图资料,并在梗死后1个月及3个月进行随访。结果 72例中共出现异常室壁运动节段382个,3组间异常室壁节段,PCI 和溶栓组在1周时收缩波峰速度(peak systolic velocity,Vs),收缩波加速度(acceleration of S wave,ACCs)及舒张早期峰速度/舒张晚期峰速度(E/A)均高于保守治疗组,在治疗后1个月到3个月时 Vs、收缩波时间速度积分(systolic velocity-timeintegral,VTIs)、ACCs 及 E/A 明显高于保守治疗组,但 PCI 组各项指标与溶栓组比较无统计学差异。结论PWDTI 评估 AMI 不同治疗对心脏局部室壁功能的影响,提示 PCI 或溶栓治疗优于保守治疗。Objective To evaluate the regional wall motion change after different therapeutic protocols in acute myocardial infarction （AMI） patients by pulsed-wave tissue doppler imaging （PWDTI）. Methods Seventy-two patients were divided into three groups： percutaneous coronary intervention group （PCI, n= 30）, thrombolysis group （n=27） and conservative therapy group （n= 15）. We quantitatively measured the movement of the infarct segments with PWDTI one week, 1 month and 3 months after AMI. Results There were 382 abnormal wall motion segments in 72 patients. The peak systolic velocities （Vs）, systolic velocity-time integrals （VTIs）, acceleration of S wave（ACCs）and the ratio e to a （E/A） were all significantly higher in PCI group and thrombolysis group than in conservative therapy group at the 1 month and 3 months after AMI. There was no significant difference between PCI group and thrombolysis group. Conclusions PCI and thrombolysis treatment can significantly improve regional wall motion compared with conservative treatment.

关 键 词：急性心肌梗死 溶栓 经皮冠状动脉介入治疗 脉冲组织多普勒成像 局部室壁运动 

分 类 号：R542.22[医药卫生—心血管疾病] R540.45[医药卫生—内科学]