左心声学造影在急性心肌梗死合并室间隔穿孔中的应用价值  

Application value of left ventricular opacification in acute myocardial infarction with ventricular septal rupture

作　　者：薛艳玲 马小静 谢姝瑞 何俊 夏娟[1] 何亚峰 Xue Yanling;Ma Xiaojing;Xie Shurui;He Jun;Xia Juan;He Yafeng(Department of Ultrasound,Wuhan Asian Heart Hospital Affiliated to Wuhan University of Science and Technology,Wuhan Cardiovascular Imaging Clinical Medical Research Center,Wuhan 430022,China)

机构地区：[1]武汉科技大学附属武汉亚洲心脏病医院超声科、武汉市心血管影像临床医学研究中心,430022

出　　处：《中华医学超声杂志（电子版）》2023年第10期1036-1039,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：武汉市科技局知识创新专项基础研究项目(2023020201010204);武汉市应用基础前沿项目(2019020701011422)。

摘　　要：目的探讨左心声学造影(LVO)在急性心肌梗死(AMI)合并室间隔穿孔(VSR)中的应用价值。方法回顾性选取2020年10月至2022年1月在武汉亚洲心脏病医院因AMI入院行床旁经胸超声心动图(TTE)检查并经LVO确诊,后行手术治疗的AMI合并VSR患者10例为研究对象。分析VSR类型及大小,以及TTE、LVO测量VSR大小与手术测量的一致性。结果10例VSR患者中,心尖部穿孔9例(9/10);单孔穿孔9例(9/10);10例均为简单型。LVO与手术对照符合率为100%(10/10)。TTE、LVO与手术3种方式对VSR大小的测值分别为(1.42±0.44)、(1.50±0.40)、(1.51±0.41)cm,差异无统计学意义(F=0.246,P=0.783)。LVO对室间隔穿孔大小的测量值与手术测量的一致性很好(ICC值:0.984,95%CI:0.936~0.996,P<0.001),明显优于TTE(ICC值:0.546,95%CI:-0.131~0.876,P=0.051)。结论LVO可为AMI合并VSR的救治提供重要的临床依据,其可作为TTE重要的补充检查方法。Objective To assess the application value of left ventricular opacification(LVO)in acute myocardial infarction(AMI)with ventricular septal perforation(VSR).Methods From October 2020 to January 2022,10 patients with AMI combined with VSR who were admitted to Wuhan Asia Cardiology Hospital,underwent bedside transthoracic echocardiography(TTE)and LVO examinations,and then underwent surgery were retrospectively selected as the study subjects.The type of VSR and the size of defect were analyzed,and the consistency of VSR measured by TTE and LVO was also analyzed.Results Among the 10 VSR patients included,9(9/10)had left ventricular apex perforation,9(9/10)had single hole perforation of the interventricular septum,and all the 10 had simple type VSR.The coincidence rate between LVO and surgical results was 100%(10/10).The values of VSR measured by TTE,LVO,and surgery were(1.42±0.44),(1.50±0.40),and(1.51±0.41)cm,respectively,with no statistical significance among them(F=0.246,P=0.783).LVO had a strong consistency with surgery for size measurement of interventricular septal perforation(interclass correlation coefficient[ICC]=0.984[0.936,0.996],P<0.001),better than that of TTE(ICC=0.546[-0.131,0.876],P=0.051).Conclusion LVO can provide an important clinical basis for the treatment of AMI combined with VSR,and it can be an important supplementary examination method for TTE.

关 键 词：左心声学造影 经胸超声心动图 急性心肌梗死 室间隔穿孔 

分 类 号：R540.4[医药卫生—心血管疾病] R542.2[医药卫生—内科学]