超声造影、ALB、Lp(a)评估AMI心肌微循环的价值  

Value of contrast-enhanced ultrasound,ALB,and Lp(a)in evaluating myocardial microcirculation in AMI

作　　者：姚晓菲 卢凯 姬亚敏[2] 陆敏姣[2] YAO Xiaofei;LU Kai;JI Yamin;LU Minjiao(Imaging Medicine and Nuclear Medicine,Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China;Ultrasonography Lab,Huzhou No.1 Hospital,Huzhou 313000,Zhejiang,China;Department of Cardiovasology,Huzhou No.1 Hospital,Huzhou 313000,Zhejiang,China)

机构地区：[1]浙江省中医药大学,浙江杭州310053 [2]湖州市第一人民医院超声医学科,浙江湖州313000 [3]湖州市第一人民医院心血管内科,浙江湖州3130001

出　　处：《中国现代医生》2024年第20期68-72,共5页China Modern Doctor

摘　　要：目的分析心肌超声造影联合血清白蛋白(albumin,ALB)、脂蛋白a[lipoprotein a,Lp(a)]对急性心肌梗死(acute myocardial infarction,AMI)患者治疗后心肌微循环功能的评价作用。方法选取2022年1月至2023年9月笔者医院收治的96例AMI患者,根据治疗后心肌微循环功能分为功能正常组56例、功能障碍组40例,比较两组院内主要心血管不良事件(major cardiovascular adverse events,MACE)、治疗48h后心肌超声造影参数平台期峰值强度(A值)、微泡再灌注上升速率(β值)、心肌血流量(A值×β值)、血清ALB、Lp(a)水平差异,明确心肌超声造影、ALB、Lp(a)评估AMI患者治疗后心肌微循环功能的价值。结果功能障碍组心肌超声造影参数A值、β值、A值×β值、血清ALB水平功能正常组,Lp(a)高于功能正常组(P<0.05)。A值、β值、A值×β值、ALB与心功能正相关,Lp(a)与心功能呈负相关(P<0.05)。超声造影联合ALB、Lp(a)评估AMI患者治疗后心肌微循环状态的效能更优(P<0.05)。功能障碍组MACE发生率高于功能正常组(P<0.05)。结论心肌超声造影可早期评价AMI患者治疗后心肌微循环功能,如与血清ALB、Lp(a)联合可提高诊断效能。Objective To evaluate the myocardial microcirculation function of patients with acute myocardial infarction(AMI)after treatment with myocardial contrast-enhanced ultrasound combined with albumin(ALB)and lipoprotein a[Lp(a)].Methods Ninety-six patients with AMI admitted to our hospital from January 2022 to September 2023 were selected.According to myocardial microcirculation function after treatment,they were divided into a normal function group(56 cases)and a dysfunction group(40 cases).major cardiovascular adverse events were compared between the two groups.major cardiovascular adverse events(MACE),the plateau peak intensity of myocardial contrast ultrasound parameters(A value),the rise rate of microbubble reperfusion(βvalue),myocardial blood flow(A value×βvalue),and serum ALB and Lp(a)levels after 48h of treatment were different,so as to determine the evaluation value of myocardial contrast ultrasound,ALB and Lp(a)on myocardial microcirculation function in AMI patients after treatment.Results In the dysfunction group,the parameters A,β,A×β,and serum ALB level,Lp(a)was higher than that in the normal function group(P<0.05).A,β,A×β,ALB were positively correlated with cardiac function,and Lp(a)was negatively correlated with cardiac function(P<0.05).CEUS combined with ALB and Lp(a)evaluated the efficacy of myocardial microcirculation in patients with AMI(P<0.05).The incidence of MACE was higher in the functional group than in the normal functional group(P<0.05).Conclusion Myocardial contrast-enhanced ultrasound can early evaluate the myocardial microcirculation function in patients with acute myocardial infarction after treatment,and combined with serum ALB and Lp(a),it can improve diagnostic efficacy.

关 键 词：急性心肌梗死 心肌微循环功能 心肌超声造影 白蛋白 脂蛋白A 

分 类 号：R542[医药卫生—心血管疾病]