多普勒推导指数评价心肌梗死患者左心室收缩及舒张功能  

Doppler-derived index for assessment of left ventricular systolic and diastolic function in patients with acute myocardial infarction

作　　者：童晓明[1] 曹培荣 张海波[2] 王华[1] 于海凤[3] 张秀明[3] 赵云鹤[3] 邱菊[1] 周荣青[1] 王志刚[4] 

机构地区：[1]山东省淄博市中心医院超声科,255036 [2]山东省淄博市中心医院急症科,255036 [3]山东省淄博市中心医院心内科,255036 [4]重庆医科大学附属第二医院超声科

出　　处：《中华超声影像学杂志》2001年第4期202-205,共4页Chinese Journal of Ultrasonography

摘　　要：目的　探讨多普勒推导指数 (DDI)在急性心肌梗死 (AMI)患者中的系列变化及对心肌功能的预测价值。方法　研究组为AMI患者 48例 ,同时选择 30例正常人作为对照组。分别在AMI发病后的 2 4h、1个月、6个月和 12个月期间进行超声随访研究 ,由二尖瓣及左室流出道多普勒频谱曲线测定左室等容收缩期时间(ICT)、等容舒张期时间 (IRT)及左室射血时间 (ET) ,其多普勒推导指数采用公式 :DDI =(ICT +IRT) /ET。结果　在AMI后 1个月及 12个月随访期间的超声指标与对照组比较 ,AMI组DDI值显著升高 (P <0 .0 0 1) ,而在随访期间DDI值降低 (P <0 .0 1)。在平均随访 (19.8± 8.8)个月期间 ,有 5例患者出现心源性猝死 ,10例患者出现充血性心力衰竭 ,8例患者出现顽固性心绞痛 ,与无心脏事件的 15例患者比较 ,其DDI值显著升高。经单变量分析DDI≥ 0 .6 0、DT≤ 14 0ms、EF≤ 40 %、前壁心肌梗死和年龄有危险因素的预测意义 (P <0 .0 0 1) ,而多变量分析确定DDI≥ 0 .6 0、DT≤ 14 0ms和年龄可作为AMI独立的预报因子 (P <0 .0 0 1)。结论　多普勒推导指数可反映左室收缩及舒张功能状态 ,对于评价AMI患者预后具有重要意义。Objective To analyse the serial changes and prognostic value of Doppler-derived index (DDI) in myocardial function of patients with acute myocardial infarction (AMI).Methods DDI was measured in 48 patients with AMI and 30 normal control group by Doppler echocardiography.The patients were studied at 24 hour,on 1,6 and 12 months after AMI.DDI 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 outlow Doppler velocity profiles.Results DDI was significantly increased at 24 hour and on 12 month (P< 0.001 ),and decreased on 1 month and 6 month of follow-up (P< 0.01 ) in patients with AMI than NC group.The DDI was significantly higher in 5 patients with sudden cardiac death,10 patients with developed congestive heart failure and 8 patients with refractory angina pectoris compared in 15 patients without cardiac event during ( 19.8 ± 8.8 ) months′ follow-up.Univariate analyses showed that DDI≥ 0.60 ,EDT≤140 ms,EF≤40%,anterior wall AMI and age were significant predictors of risk.Multivariate analysis showed that DDI≥ 0.60 ,DT≤140 ms,EF≤40% and age were independent predictors of outcome.Conclusions The DDI reflects the condition of left ventricular systolic and diastolic myocardial function ,it can be used as a reliable adjunctive index of myocardial function.

关 键 词：超声心动描记术 心肌梗塞 心室功能 多普勒推导指数 

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