药物负荷超声心动图对急性心肌梗死患者的预后评估研究  

Low-dose dobutamine stress echocardiography for prognostic evaluation of patients with acute myocardial infarction:a 5-year follow-up

作　　者：刘泽军[1] 蒋云山[2] 陈伍英 

机构地区：[1]湖南省永州市职业技术学院附属医院超声医学科,永州425100 [2]湖南省永州市人民医院超声医学科,永川425100

出　　处：《重庆医科大学学报》2010年第5期756-759,共4页Journal of Chongqing Medical University

摘　　要：目的:探讨小剂量多巴酚丁胺负荷超声心动图(Low-dose dobutamine stress echocardiography,LDDSE)在急性心肌梗死预后中的评价作用。方法:对2004年符合标准的我院心内科47例急性心肌梗死患者病情稳定后进行LDDSE检查,并进行为期5年的系统随访。结果:LDDSE试验过程中无患者出现严重并发症,而整体心功能增强的趋势,表现为LVED缩小、LVEF增高(P<0.05)和WMSI的减少(P<0.05)。5年随访内共失访3例,随访率93.6%。23例死亡,其1、3、5年生存率分别为86.5%、63.2%和42.7%。而超声指标中WMSI对5年生存预后鉴别力最佳,AUC为0.717,95%CI为0.614～0.820(P=0.0001)。而发病时WMSI也是影响其的预后独立危险因素(P<0.05)。结论:小剂量多巴酚丁胺负荷超声心动图的室壁运动检查对急性心肌梗死患者5年生存预后有较好鉴别力,WMSI是影响其预后的独立危险因素。Objective：To investigate the prognostic value for low-dose dobutamine stress echocardiography（LDDSE）in patients with acute myocardial infarction.Methods：In 2004,47 patients with acute myocardial infarction in stable condition were given LDDSE checks in our hospital,and conduct follow-up period of 5 years.Results：No patients with serious complications in LDDSE,the overall cardiac function improved,expressed as LVED decreased,LVEF increased（P〈 0.05）and WMSI reduced（P 〈0.05）.A total of 3 patients lost in 5-year follow-up,the follow-up rate was 93.6%,and 23 patients dead,the 1,3,5 year survival rates were 86.5%,63.2% and 42.7%.The WMSI discernment best for the five-year survival prognosis,AUC = 0.717,95% CI 0.614-0.820（P=0.000 1）.The WMSI was also an independent risk factor for acute myocardial infarction（P〈0.05）.Conclusion：Low-dose dobutamine stress echocardiography have good discernment for 5-year survival prognosis of acute myocardial infarction,and the WMSI was the independent prognostic risk factors.

关 键 词：急性心肌梗死 负荷超声心动图 多巴酚丁胺 预后 

分 类 号：R445.1[医药卫生—影像医学与核医学]