急性前壁心肌梗死患者PCI手术前后左室重构的实时三维超声心动图评价  

Evaluating Left Ventricular Remodeling and Its Clinical Value in Patients with PCI by Real-time Three-dimensional Echocardiography

作　　者：田芳[1] 周微微[2] 杨炳昂[1] 钟文津[1] 唐海霞[1] 

机构地区：[1]海南省人民医院超声科,海南海口570311 [2]沈阳军区总医院特诊科,辽宁沈阳110016

出　　处：《创伤与急危重病医学》2015年第4期228-231,共4页Trauma and Critical Care Medicine

摘　　要：目的探讨实时三维超声心动图(RT-3DE)评价急性前壁心肌梗死患者行冠状动脉介入(PCI)术前后左室重构的临床价值。方法将2012年3月至2014年12月体检及就诊的56例研究对象分为对照组24例(正常体检者)及PCI组32例(就诊者)。在软件上分析对照组及PCI组术前、术后7 d、术后1个月、术后3个月的图像,分别得到左心室质量(LVM)、左心室舒张末期容积(LVEDV)、左心室射血分数(LVEF)、整体峰值射血率(g PER)及整体峰值充盈率(g PFR)并计算得到左室重构指数(LVRI),比较PCI组术前及术后各时间点与对照组各参数的差异性及PCI组各时间点之间各参数的差异性。结果 PCI组术前各参数与对照组比较,差异有统计学意义(P<0.01);术后7 d及术后1个月较术前各参数均有所增高,差异有统计学意义(P<0.05);术后3个月较术前改变尤为明显,差异有统计学意义(P<0.01);术后3个月与对照组比较,差异无统计学意义。结论 PCI术可以逆转急性前壁心肌梗死患者的左室重构。RT-3DE测量所得的LVEF、LVRI、g PER及g PFR可以准确定量评价左室重构程度。Objective To investigate the clinical value of real-time three-dimensional echocardiography（ RT-3DE） in evaluation of left ventricular remodeling（ LVR） changes pre- and post- percutaneous coronary intervention（ PCI） in patients with acute anterior myocardial infarction. Methods 56 patients were divided into normal control group（ 24 cases） and PCI group（ 32 cases）. The left ventricle volume image of normal control group and PCI group were analyzed offline by RT-3D examination,and left ventricular ejection fraction（ LVEF）,the global peak ejection rate（ g PER）,the global peak filling rate（ g PFR） and the left ventricular remodeling index（ LVRI） were obtained. The difference of all parameters between normal control group and PCI group including pre-PCI,7d post-PCI subgroup,1 month post-PCI subgroup and 3 month post-PCI subgroup were compared. Results All parameters of pre-PCI were significantly lower than normal control group＇s（ P〈0. 01）. All parameters of 7d post-PCI subgroup and 1 month post PCI subgroup were better than pre-PCI（ P〈0. 05）,and 3month post-PCI subgroup were obviously better than pre-PCI. There were no significant differences of all parameters between3 month post-PCI subgroup and normal control group（ P〉0. 05）. Conclusion PCI can reverse the left ventricular remodeling in patients with acute anterior myocardial infarction. The LVEF,LVRI,g PER and g PFR obtained by RT-3DE can evaluate the degree of left ventricular remodeling.

关 键 词：实时三维超声心动图 急性前壁心肌梗死 冠状动脉介入治疗 左室重构 

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