组织多普勒与实时三维超声心动图联合评价左室重构在老年AMI行急诊PCI中的价值  

THE VALUE OF ACUTE PCI IN AMI IN THE ELDERLY BY ADOPTING TISSUE DOPPLER IMAGING COMBINED WIITH REAL-TIME THREE DIMENSIONAL ECHOCARDIOGRAPHY IN EVALUATION OF LEFT VENTRICULAR REMODELING

作　　者：郭爱华 解东兴 石慧武 王宝杰 姜玉凤[4] 杨静[4] 贾梦颖 饶莉 郭爱茹 

机构地区：[1]河北省唐山市工人医院集团康复医院,063000 [2]唐山市工人医院超声心动室 [3]唐山市工人医院ICU [4]唐山市工人医院心内科 [5]唐山市工人医院风湿免疫科

出　　处：《中国煤炭工业医学杂志》2014年第12期1925-1928,共4页Chinese Journal of Coal Industry Medicine

基　　金：唐山市2013年科技计划项目(编号:13130254a)

摘　　要：目的应用组织多普勒成像技术（TDI）与实时三维超声心动图（RT-3DE）联合评价急诊经皮冠状动脉介入治疗（PCI）及常规药物治疗对老年人（65~75岁）首发急性前壁心肌梗死后左心室重构（LVRM）的影响,评价其临床应用价值。方法对2010年6月—2013年12月于唐山市工人医院确诊为急性前壁心肌梗死的老年人,A组225例患者行急诊PCI治疗;B组150例患者行常规药物治疗,于就诊后即刻（6h内）、PCI术后及常规药物治疗即刻,治疗后2个月及6个月进行超声心动图观察。所测参数有：左室舒张末期容积（LVEDV）、左室收缩末期容积（LVESV）、左室射血分数（LVEF）、二尖瓣环舒张早期与舒张晚期运动峰值速度之比（Ea/Aa）、梗死区的局部室壁运动指数（RWMI）。结果 A组结果观察得出,LVEDV、LVESV、RWMI随检测时间延长逐渐降低,术后2个月和6个月较前显著降低;LVEF、Ea/Aa逐渐升高;B组结果观察得出,LVEDV、LVESV、RWMI呈缓慢降低,LVEF、Ea/Aa逐渐升高;6个月后组间比较得出,LVEDV、LVESV、RWMI,A组明显低于B组,LVEF、Ea/Aa,A组明显高于B组。结论 TDI与RT-3DE数据联合能准确测定左心室重构,有助于评价老年AMI患者行急诊PCI后的效果;老年AMI行急诊PCI远期预后优于常规药物治疗,有助于左室收缩和舒张功能的恢复,有效减轻左心室重构。Objective Through application of Doppler tissue imaging（TDI）combined with real-time three-dimensional echocardiography Beckoning graph（RT-3DE）to evaluate the emergency percutaneous coronary intervention（PCI）and conventional drug treatment for the elderly（65~75 years old）of left ventricular remodeling after myocardial infarction in the first acute anterior wall（LVRM）effect,and its clinical application.Methods The elderly patients treated during June 2010 to December 2013 at Tangshan Gongren Hospital diagnosed with acute anterior wall myocardial infarction were selected,group A of 225 patients were treated with emergent PCI;Group B of 150 patients were under treatment with conventional medicine given immediately after treatment（within 6 hours）,and they were given conventional drug therapy immediately after PCI.After treatment of two months to six months,treatment for ultrasonic cardiograph observations was administered.The measured parameters were：left ventricular end-diastolic volume（LVEDV）,left ventricular end-systolic volume（LVESV）,left ventricular ejection fraction（LVEF）,early and late diastolic mitral diastolic peak velocity of exercise（Ea/Aa）,regional wall motion index of the infarction area（RWMI）.Results Group A and group B were given immediately ultrasound treatment,the comparison of LVEDV,LVESV,LVEF,Ea/Aa and RWMI indicators were showed no statistical significance.LVEDV,LVESV,LVEF and RWMI indicators of Group A immediately after operation and indicators ofB group immediately after drug treatment were compared,the results showed no statistical significance.But the indicator of Ea/Aa was statistical significance between the two groups.By comparing the result of review treatment of patients from group A and group B after two and six months,LVEDV,LVESV,LVEF,Ea/Aa,RWMI indicators were statistically significance.Conclusion By using TDI and RT-3DE data,left ventricular heavy frame can be accurately determined which helps to evaluate emergent PCI effect of elderly AMI

关 键 词：组织多普勒 实时三维超声心动图 急性心肌梗死 左心室重构 经皮冠状动脉介入治疗 老年人 

分 类 号：R522.2[医药卫生—内科学]