小剂量多巴酚丁胺超声心动图对冠心病存活心肌的评估  

Low-dose Dobutamine Echocardiography Evaluating Viable Myocardium in Patients with Coronary Heart Disease

作　　者：任志亮 杨丽云 

机构地区：[1]内蒙古自治区人民医院心内科,内蒙古呼和浩特010017

出　　处：《内蒙古医学杂志》2011年第6期641-644,共4页Inner Mongolia Medical Journal

摘　　要：目的:采用小剂量多巴酚丁胺负荷超声心动图(LDDSE)对冠心病患者进行存活心肌的检测,并将其结果进行分析。方法:受试者60例,包括急性心肌梗死(AMI)、陈旧性心肌梗死(OMI)、不稳定型心绞痛(UA)3组各20例。试验前安静状态下分别记录患者心率(HR)、血压(BP)、心电图(ECG)、标准二维超声心动图(2DE)图像,然后以5μg/(kg.min)、10μg/(kg.min)的速度静脉输注多巴酚丁胺(Dob)各5 min,重新记录2DE图像,于2周后回放,用目测法半定量分析图像。结果:AMI、OMI、UA 3组患者,存活心肌检出率分别为50.7%、51.4%、69.8%。UA组患者存活心肌检出率高于其余两组(P<0.05)。Dob10μg/(kg.min)滴注后心率、收缩压较前升高,但舒张压差异无统计学意义(P>0.05)。与未用药时对比,Dob输注后射血分数明显提高。结论:小剂量多巴酚丁胺超声心动图对冠心病患者进行存活心肌的评估是可行的,且方便、安全,无创。对于UA患者,其存活心肌检出率偏高。Objective：Using of low-dose dobutamine stress echocardiography（LDDSE） detect of viable myocardium for the three groups of patients with coronary heart disease,and then analyze the results.Methods： Subjects are 60 cases,including acute myocardial infarction（AMI）,old myocardial infarction（OMI）,unstable angina（UA） three groups,each group have 20 cases.Record the heart rate（HR）,blood pressure（BP）,electrocardiogram（ECG） and the standard two-dimensional echocardiography（2DE） images for all patients before the experiment,and then intravenous infusion of dobutamine（Dob） at the rate of 5 μg/（kg·min） and 10 μg/（kg·min）,each dose lasts 5 minutes.To re-record standard 2DE images,after two weeks 2 DE video playback,analyze the images using visual images.Results：AMI,OMI,UA three groups of patients,myocardial viability detection rates are 50.7%,51.4% and 69.8%.Myocardial viability detection rate of unstable angina is higher than other two groups.After Dob 10 μg/（kg·min） infusion,HR,systolic blood pressure higher than before,the numerous of EF is higher than before too.However,no significant change in diastolic pressure（P〉0.05）.Conclusion：Low-dose dobutamine echocardiography in patients with coronary heart disease myocardial viability assessment is feasible,convenient,safe,and non-invasive.To unstable angina patients,the rate of viable myocardium is higher.

关 键 词：存活心肌 多巴酚丁胺 超声心动图 

分 类 号：R542.22[医药卫生—心血管疾病]