急性心梗后心肌组织特征与早期再灌注和预后的关系  

Quantitative Analysis of Echodensity Alterations in Patients with Myocardial Infarction and Relation to Reperfusion

作　　者：沈学东[1] 娄大元[1] 何梅先[1] 张高星[1] 钱菊英[1] 胡英[1] 陈灏珠[1] 

机构地区：[1]上海医科大学中山医院,200032

出　　处：《中国超声医学杂志》1999年第9期651-655,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的⑶评价急性心肌梗塞患者心肌超声组织特征变化趋势与预后的关系以及早期再灌注对心肌组织密度的影响⒚方法⑶我们分析了首次发病的 ６９ 例 Ｑ 波急性心肌梗塞患者入院后 ２４ 小时内、７２ 小时、２ 周、３ 个月和６ 个月的心肌灰阶⒚根据患者有无早期再灌注分为⑶无早期再灌注组 ４６ 例⒙早期再灌注组 １６ 例和死亡组 ７ 例⒚结果⑶在无早期早再灌注组⒙梗塞区心肌灰阶的均值、离散度于入院 ３ 个月后明显高于入院时 ⒉ Ｐ＜ ００ ５⒕⒚早期再灌注组梗塞区心肌灰阶的均值、离散度在入院 ２ 周即开始逐渐下降 ⒉ Ｐ＜ ００５⒕⒚死亡组梗塞区的心肌灰阶值在入院 ７２ 小时后即明显增加 ⒉ Ｐ＜ ００Objective:To evaluate the alterations of myocardial echodensity and relation to reperfusion in patients with acute myocardial infarction.Methods:Sixty nine myocardial infarction patients with first q wave were studied by echocardiography at 24 hour,72 hour,2 weeks,3 months and 6 months after admission respectively.The mean gray scale,standard deviation,median,maximal value,minimal value and superiority gray scale of the myocardium were analyzed by computer assistant quantitative analysis of myocardial echodensity.The patients were divided into reperfusion group(16 cases)and non reperfusion group(46 cases).Results:In the group of non reperfused patients,the mean gray level and thd standard deviations increased significantly in the infarct regions after 3 months.The same indexes of no infarct regions became lower in the 6th month than those in the 3rd month in patients with anterior wall infarction.In reperfusion group,the myocardial density of remain region showed no changes during the follow up.In the death group,the myocardial density of the involved regions increased progressively in 72 hours( P <0 05).However,in group of non reperfused patients(controll group),the myocardial density had no changes during this time( P >0 05).Conclusion:The quantitative analysis of echodensity shows myocardial tissue pathophysilogical alterations after myocardial infarction and ventricular remodeling.This method seems to be an effective and practicable one to detect structural changes of myocardium.

关 键 词：急性 心肌梗塞 心肌组织特征 再灌注 预后 

分 类 号：R542.22[医药卫生—心血管疾病]