急性心肌梗死患者Tei指数与左心室充盈模式及预后的关系  

Association between Tei index and left ventricular filling models as well as prognosis in patients with acute myocardial infarction

作　　者：史卫国[1] 牟晓雯[1] 孙学玉[1] 宁红红[1] 罗晴霞[2] 

机构地区：[1]青岛市第八人民医院,山东青岛266100 [2]青岛市海慈医院,山东青岛266000

出　　处：《中国临床医学影像杂志》2009年第6期408-411,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨首次急性心肌梗死(AMI)患者Tei指数与左心室充盈模式及预后的关系。方法:对165例AMI患者的超声心动图参数进行检测。由二尖瓣及左心室流出道多普勒血流频谱曲线测定左心室等容舒张时间(IRT)、等容收缩时间(ICT)及左心室射血时间(ET)。左心室Tei指数=(ICT+IRT)/ET。依据二尖瓣E波减速时间(EDT)和左心室舒张早期血流传播速度(Vp)将165例AMI患者分为正常充盈组、松弛性减低组、假性正常化组、限制性充盈组。应用Cox比例风险模型分析患者远期存活的风险预测。结果:165例AMI患者中,正常充盈43例、松弛性减低55例、假性正常化35例、限制性充盈32例。与正常充盈组比较,松弛性减低组、假性正常化组、限制性充盈组的Tei指数增大(P<0.05～0.01);限制性充盈组的左心室舒张末期容积指数(EDVI)和收缩末期容积指数(ESVI)增加(P<0.05～0.01)。平均随访12(0～17)个月时,22例患者死亡。死亡组的Tei指数与生存组的Tei指数比较,差异有显著性意义(P<0.01)。Cox模型生存分析显示Tei指数≥0.6为死亡的独立危险因子(相对危险系数为3.997,P=0.028)。结论:AMI患者Tei指数与左心室充盈模式有关,能够反映左心室功能障碍的严重程度,是AMI后患者死亡的独立预测因子。Objective： To investigate the correlation of Tei index with left ventricular filling models and prognosis in pa- tients with acute myocardial infarction （AMI）. Methods： One hundred and sixty-five patients with AMI were studied with e- chocardiography. Tei index was defined as the sum of isovolumetric contraction time （ICT） and isovolumetric relaxation time （IRT） divided by ejection time（ET）, which were measured from mitral flow and left ventricular outflow Doppler velocity profiles. According to mitral E-wave deceleration time （EDT） and early diastolic flow propagation velocity （Vp）, a total of 165 patients with AMI were divided into normal filling, impaired relaxation, pseudo-normal and restrictive filling group. Multivariate Cox proportional hazards analysis was performed to identify independent predictors of cardiac death. Results： Left ventricular filling was normal in 43 cases; impaired relaxation in 55 cases; pseudo-normal in 35 cases; and restrictive in 32 cases. Compared with normal filling group, Tei index was higher in impaired relaxation, pseudo-normal and restrictive group （P〈0.05-0.01）; left ventricular end-diastolic volume index （EDVI） and end-systolic volume index （ESVI） were significantly increased in restrictive group （P〈0.05-0.01）. During follow-up of 12（range 0-17） months, 22 patients（13.3%） died. Compared with surviving group, Tei index was higher in cardiac death group （P〈0.01）. Cox analysis illustrated that Tei index was a powerful predictor of cardiac death （relative hazard coefficient is 3.997, P=0.028）. Conclusions： Tel index reflects severity of left ventricular dysfunction and have independent prognostic value in patients with AMI.

关 键 词：心肌梗塞 超声心动描记术 

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