彩色多普勒超声心动图在心肌梗死并发室壁瘤诊断中的效果分析  

Application effect of color Doppler echocardiography in the diagnosis of myocardial infarction complicated by ventricular aneurysm

作　　者：李林 梁金文 王艳玲 Li Lin;Liang Jinwen;Wang Yanling(Henan Rong jun Hospital,Xinxiang 453000,Henan,China)

机构地区：[1]河南省荣军医院,河南新乡453000

出　　处：《临床心身疾病杂志》2025年第2期32-35,共4页Journal of Clinical Psychosomatic Diseases

摘　　要：目的 探讨彩色多普勒超声心动图(CDE)在心肌梗死并发室壁瘤诊断中的应用效果。方法 采用常规心电图与CDE对84例疑似心肌梗死并发室壁瘤患者进行检查,并以左心室造影(LVC)检查为“金标准”,分析两种检查方式的诊断结果、诊断效能及对不同部位心肌梗死并发室壁瘤的检出率,探讨常规心电图检查ST-T抬高幅度与CDE检查左心室舒张末内径(LVEDD)、左心室收缩末内径(LVESD)、左心室射血分数(LVEF)、左心室壁运动幅度(LVWMA)等心功能的相关性。结果 84例疑似心肌梗死并发室壁瘤患者中,经LVC检查确诊阳性68例,阴性16例,其中室壁瘤合并附壁血栓25例。经CDE检查诊断阳性66例,阴性15例,其中室壁瘤合并附壁血栓24例;经常规心电图检查诊断阳性54例,阴性14例,其中室壁瘤合并附壁血栓22例。两种检查方式的特异性、误诊率以及对侧壁、下壁心肌梗死并发室壁瘤检出率比较,差异均无统计学意义(P>0.05)。CDE检查的敏感性、准确性较常规心电图检查高,漏诊率较常规心电图检查低,且对前壁及左室心尖部心肌梗死并发室壁瘤检出率较常规心电图检查高(P<0.05或0.01)。常规心电图检查ST-T抬高幅度与CDE检查LVEDD、LVESD、LVWMA呈正相关,与CDE检查LVEF呈负相关(P<0.01)。结论 CDE检查在心肌梗死并发室壁瘤患者中的诊断效能较高,并能准确检出室壁瘤位置。Objective To explore the application effect of color Doppler echocardiography(CDE)in the diagnosis of myocardial infarction complicated by ventricular aneurysm.Methods Eighty-four patients with suspected myocardial infarction complicated by ventricular aneurysm were examined using conventional elect rocardiography(ECG)and CDE,lef t vent r icula r cineangiography(LVC)examinations used as the‘gold standard’,diagnostic results,diagnostic efficacy and the detection rate of myocardial infarction complicated by ventricular aneurysm in different parts by the two examination methods analyzed,and the correlation of ECG ST-T elevation with CDE cardiac functions such as left ventricular end-diastolic internal diameter(LVED),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF)and left ventricular wall motion amplitude(LVWMA)explored.Results Among the 84 patients with suspected myocardial infarction complicated by vent r icular aneurysm,68 were positive and 16 negative,and 25 vent r icular aneurysm combined with mural thrombus by LVC examination;sixty-six patients were positive,15 negative,and 25 vent r icular aneurysm combined with mural thrombus by CDE examination;fif ty-four patients were positive,14 negative,and 22 vent r icula r aneurysm combined with mural thrombus by conventional ECG examination.Differences of the two methods in specificity,misdiagnosis rate,and detection rate of lateral and inferior myocardial infarction complicated by ventricular aneurysm weren't statistically significant(P>0.05).Compared with conventional ECG examination,the sensitivity and accuracy of CDE examinat ion were higher,the rate of missed diagnosis was lower,and the detection rate of myocardial infarction complicated by ventricular aneurysm in anterior wall and left ventricular apical part higher(P<0.05 or 0.01).ECG ST-T elevation was positively correlated with CDE LVEDD,LVESD,and LVWMA and negatively with CDE LVEF(P<0.01).Conclusion CDE examination has higher diagnostic efficacy in patients with myoc

关 键 词：心肌梗死 室壁瘤 彩色多普勒超声心动图 诊断效能 

分 类 号：R542.2[医药卫生—心血管疾病] R540.45[医药卫生—内科学]