实时三维超声心动图评价球囊缺血后适应对急性前壁心肌梗死患者心脏收缩功能的作用  

Real time three-dimensional echocardiography to evaluate the effect of adaptation after balloon ischemia on systolic function in patients with acute anterior wall myocardial infarction

作　　者：张丽华[1] 杜超[2] 曹亚坤[1] 赵刚[1] 王雁[1] 秦利强[2] ZHANG Lihua;DU Chao;CAO Yakun;ZHAO Gang;WANG Yan;QIN Liqiang(Department of Ultrasound,Third Hospital of Shijiazhuang City,Hebei Province,Shijia zhuang 050017,China)

机构地区：[1]石家庄市第三医院超声科,050017 [2]石家庄市第三医院心内一科,050017

出　　处：《疑难病杂志》2019年第11期1086-1090,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：石家庄市科技支撑计划项目(181460523)

摘　　要：目的应用实时三维超声心动图(RT-3DE)评价球囊缺血后适应对急性前壁心肌梗死患者心脏收缩功能的影响。方法选取2018年1月—2019年5月在石家庄市第三医院诊断为急性ST段抬高型前壁心肌梗死且行介入治疗患者62例,随机数字表法分为对照组(n=31)和试验组(n=31)。对照组按照常规操作完成介入治疗,试验组使用球囊缺血后适应技术完成介入治疗。分别于术前和术后1周、3个月进行RT-3DE检查,应用17节段时间—容积曲线分析,得到左心室整体及左心室前壁各节段收缩末期容积(rESV)、左心室舒张末期容积(rEDV),计算左心室各节段射血分数(rEF),对其收缩功能进行评价。结果2组术前左室收缩功能及各节段收缩功能指标比较差异无统计学意义(P>0.05),术后1周时左心室LVESV、LVEDV及各节段rESV、rEDV较术前略有下降,LVEF、rEF较术前略有上升,但与术前比较差异无统计学意义(P>0.05),且组间比较亦无统计学意义(P>0.05);2组术后3个月时LVESV、LVEDV及左心室前壁各节段rESV、rEDV较术前明显下降(P<0.05),LVEF及左心室前壁各节段rEF较术前明显上升(P<0.05),且试验组术后3个月时左心室LVESV、LVEDV及前壁各节段rESV、rEDV低于同期对照组(P<0.05),LVEF、rEF高于同期对照组(P<0.05)。结论球囊缺血后适应技术后行介入治疗能够提高患者心脏收缩功能,RT-3DE能更好地显示心脏整体和局部的解剖和空间关系,准确地评价左心功能,可为优化介入操作提供参考依据。Objective Real time three-dimensional echocardiography(RT-3DE)was used to evaluate the effect of adaptation after balloon ischemia on systolic function in patients with acute anterior wall myocardial infarction.Methods From January 2018 to may 2019,62 patients with acute ST segment elevation anterior wall myocardial infarction diagnosed in the Third Hospital of Shijiazhuang City were randomly divided into control group(n=31)and experimental group(n=31).The control group completed the interventional therapy according to the routine operation.In the experimental group,the interventional therapy was completed by the adaptive technique after balloon ischemia.RT-3DE was performed before operation and 1 week and 3 months after operation.By analyzing the 17-segment time volume curve,the end systolic volume(rESV)and end diastolic volume(rEDV)of the whole and anterior wall of the left ventricle were obtained.The ejection fraction(rEF)of each segment of the left ventricle was calculated and its systolic function was evaluated Results There was no significant difference in the left ventricular systolic function and systolic function indexes between the two groups(P>0.05).The left ventricular LVESV,LVEDV and rESV and rEDV of each segment decreased slightly compared with the preoperative one week.LVEF and rEF increased slightly compared with preoperative,but there was no significant difference between the two groups(P>0.05),and there was no significant difference between the two groups(P>0.05).The rESV and rEDV of LVESV,LVEDV and left ventricular anterior wall were significantly lower than those before operation(P<0.05).The rEF of LVEF and left ventricular anterior wall were significantly higher than those before operation(P<0.05).The rESV and rEDV of left ventricle LVESV,LVEDV and anterior wall were lower than the control group at the 3rd month(P<0.05),and LVEF and rEF were higher than the control group(P<0.05).Conclusion RT-3DE can better show the anatomic and spatial relationship between the whole heart and the local heart

关 键 词：实时三维超声心动图 急性前壁心肌梗死 球囊缺血后适应 经皮冠状动脉介入治疗 节段性收缩功能 

分 类 号：R54[医药卫生—心血管疾病]