机构地区:[1]海南省人民医院超声科,海南海口570311 [2]海南省人民医院核医学科,海南海口570311
出 处:《创伤与急危重病医学》2020年第3期186-189,193,共5页Trauma and Critical Care Medicine
摘 要:目的探讨实时三维超声心动图(RT3DE)与门控心肌灌注显像(GMPI)在急性心肌梗死(AMI)患者行延迟经皮冠状动脉介入治疗(PCI)前后左心功能评价中的临床价值。方法选取自2015年12月至2018年12月海南省人民医院收治的32例AMI患者纳入心梗组,将临床和辅助检查排除心脏疾病及其他影响心脏功能疾病的正常人28例纳入正常组。心梗组患者入院后行PCI手术治疗,并于PCI术前及术后1个月行RT3DE及GMPI检查;正常组于入院检查1个月内行RT3DE及GMPI检查。分析两组RT3DE及GMPI的左心室图像,比较心梗组PCI术前及术后1个月与正常组左心室舒张末期容积(LVEDV),左心室收缩末期容积(LVESV)及左心室射血分数(LVEF)值等参数的差异性,并分析RT3DE与GMPI各参数的相关性。结果与正常组比较,心梗组术前及术后1个月LVEDV、LVESV增加,LVEF值降低,差异均有统计学意义(P<0.05);心梗组术后1个月LVEDV、LVESV及LVEF值与术前比较,差异均有统计学意义(P<0.05)。心梗组患者RT3DE与GMPI测得的LVEDV、LVESV相关性良好,延迟PCI术前r值分别为0.918和0.937,术后r值分别为0.900和0.757;LVEF相关性一般,术前r值为0.438,术后r值为0.496。RT3DE及GMPI测得的术前LVEDV、LVESV及LVEF的一致性仅有3%(1/32)的点在一致性界限外;术后1个月,LVEDV、LVESV有3%(1/32)的点在一致性界限外,LVEF所有点均在界限内。结论RT3DE与GMPI评价AMI患者延迟PCI术前及术后左心功能参数的相关性及一致性较好,临床上可根据需要联合应用以评价AMI患者延迟PCI术前及术后的左心功能。Objective To investigate the clinical value of real-time three-dimensional echocardiography(RT3 DE)and gated myocardial perfusion imaging(GMPI)in left ventricular function evaluation before and after delayed percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods Thirty-two AMI patients who were admitted from December 2015 to December 2018 were included in the myocardial infarction group,and the other 28 normal people who were excluded from heart disease or other diseases affecting heart function by clinical and other auxiliary examinations were included in the normal group.Myocardial infarction group of patients underwent PCI after hospitalization,patients were performed RT3 DE and PCI GMPI examination 1 month before and 1 month after PCI.Normal group of patients were performed RT3 DE and PCI GMPI examination after hospitalization within 1 month.The left ventricular images of RT3 DE and GMPI in the two groups were analyzed to compare the differences between the left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV)and left ventricular ejection fraction(LVEF)values and other parameters of the myocardial infarction group before and one month after PCI and those of the normal group,and to analyze the correlation between RT3 DE and GMPI parameters.Results Compared with the normal group,LVEDV and LVESV increased and LVEF reduced in the myocardial infarction group before and 1 month after operation(P<0.05).The values of LVEDV,LVESV and LVEF in the myocardial infarction group 1 month after the operation were statistically significant compared with those before the operation(P<0.05).The correlation between RT3 DE and LVEDV and LVESV measured by GMPI was good.The r before delayed PCI were 0.918 and 0.937,and the r after delayed PCI were 0.900 and 0.757,respectively.The correlation of LVEF was general,with preoperative r of 0.438 and postoperative r of 0.496.The consistency of preoperative LVEDV,LVESV and LVEF measured by RT3 DE and GMPI was only 3
关 键 词:实时三维超声 门控心肌灌注显像 延迟经皮冠状动脉介入治疗 左心功能
分 类 号:R542[医药卫生—心血管疾病]
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