心肌梗死患者心肌超声背向散射积分变化及其临床价值  

Studies on the changes and clinical value of myocardial integrated backscatter in patients with acute myocardial infarction

作　　者：郭沫化 缪英[2] 倪锐志[2] 

机构地区：[1]武警云南总队医院内一科,云南昆明650111 [2]昆明医学院第一附属医院心内科,云南昆明650031

出　　处：《武警医学院学报》2007年第4期382-385,共4页Acta Academiae Medicinae CPAPF

摘　　要：【目的】探讨超声背向散射积分技术(IBS)评价急性心肌梗死(AMI)患者局部心肌的声学组织特征变化及在择期冠脉介入(PCI)手术疗效中的价值。【方法】20例AMI患者,分别在择期PCI术前及术后7 d用声学定量技术(AQ)测定左室射血分数(EF),彩色室壁运动分析技术(CK)测量心内膜收缩期位移值(ESE),并根据CK图像中彩色阶带的宽度将心肌室壁运动异常节段分3组;IBS检测3组及20例健康人相同节段心肌的IBS参数(IBS%、CVIB%)。【结果】对于Ⅰ组和Ⅱ组室壁运动异常节段心肌,PCI术前其IBS%较健康对照组增加、CVIB%降低,PCI术后其IBS%较术前降低、CVIB%增加(P<0.05)、EF增加(P<0.01),且CVIB%的增加与EF的增加呈正相关(P<0.05)。【结论】IBS技术可反映AMI患者局部心肌的组织特征及识别存活心肌,为客观评价PCI手术疗效提供依据。[Objective] To assess the tissue characterization of abnormal segments and the clinical value in patients with acute myocardial infarction （AMI） after selective percutaneous coronary intervention （PCI） by integrated backscatter （IBS）. [Methods] Twenty patients with AMI were assessed by acoustic quantification （AQ）, color kinesis （CK） and IBS before and seven days after revascularization. Ejection fraction （EF） was measured by AQ; endocardial systolic excursion （ESE） was assessed by CK, then the patients were divided into three groups according to the width of color excursion. The normal integrated backscatter （IBS%） and the normal cardiac variation magnitude of integrated backscatter （CVIB%） were detected by IBS in myocardium of different regional wall in patents and compared with that of the controis. [Results] Before PCI, the IBS% of abnormal regional wall motion increased and the CVIB% blunted in group Ⅰ and group Ⅱ as compared with control group. The IBS% of abnormal segments decreased and the CVIB% increased in group Ⅰ and group Ⅱ after PCI （ P 〈 0.05）. The index of global contractile function of left ventricular , such as ejection fraction （EF） was increased after PCI （ P 〈 0.01）. And the increments of CVIB% in abnormal regional wall motion were correlated positively with the increase of EF of the left ventricular （ P 〈 0.05）. [Conclusion] IBS can reveal tissue characterization and innate contract ability of the regional myocardium and identify the viable myocardium. It provides an objective way of evaluating the effects of PCI and assessing the clinical prognosis of patients with AMI.

关 键 词：超声背向散射积分 存活心肌 冠脉介入 

分 类 号：R543.3[医药卫生—心血管疾病]