多巴酚丁胺负荷超声心动图与背向散射积分对陈旧性心肌梗死患者心肌存活性的研究  

Clinical studies of myocardial integrated backscatter in old myocardial infarction patients during dobutamine stress

作　　者：郭瑞强[1] 张峻[1] 刘岚[1] 孙有刚[1] 尹家保[1] 李庚山[2] 黄从新[2] 

机构地区：[1]武汉大学人民医院超声影像科,430060 [2]武汉大学人民医院心内科,430060

出　　处：《中华超声影像学杂志》2003年第4期207-211,共5页Chinese Journal of Ultrasonography

基　　金：湖北省教育厅课题资助项目 (99A0 61 )

摘　　要：目的　探讨小剂量多巴酚丁胺负荷超声心动图与背向散射技术评估陈旧性心肌梗死患者的心肌存活性。方法　分别测量 2 8例心肌梗死患者在不同负荷阶段时 (注药剂量分别为 0 ,5 ,10 ,2 0μg·kg-1·min-1) ,胸骨旁左心室乳头肌水平短轴观的 4个节段 (前室间隔、前壁、后壁和下壁 )的背向散射积分周期变异 (CVIB)和标化背向散射积分周期变异 (CVIB % ) ,并在冠状动脉重建术后随访常规超声心动图。结果　非心肌梗死组及非存活心肌组的CVIB和CVIB %在小剂量多巴酚丁胺负荷过程中无显著变化 ,而存活心肌组CVIB和CVIB %均在 5～ 10 μg·kg-1·min-1时增加并保持较高水平至负荷终点。结论　陈旧性心肌梗死患者的心肌背向散射积分参数在小剂量多巴酚丁胺负荷状态下呈现出有意义的改变 ,两种方法的结合可用于定量检测存活心肌。ObjectiveTo discuss the myocardial integrated backscatter (IB) characterization in old myocardial infarction (OMI) patients during the low dose dobutamine stress echocardiography (DSE). Methods Twenty eight OMI patients underwent 4 stages low dose DSE (0, 5, 10 and 20 μg·kg -1 ·min -1 dobutamine infusion).The cardiac variation of IB (CVIB) and calibrated CVIB (CVIB%) were measured according to different segments (anterior septum, anterior wall, inferior wall and post wall of left ventricle) in different stages.ResultsIn the viable segments (Group C), CVIB and CVIB% increased from low level in early stage (5～10 μg·kg -1 ·min -1 ) then maintaining in high level to the endpoint (20 μg·kg -1 ·min -1 ), while maintained high level in control segments (Group A). Both CVIB and CVIB% were lower in non viable segments(Group D) than in Group A without changing during all stages. ConclusionsThe indexes of IB under dobutamine infusion were valuable for the quantitative evaluating the contractility of myocardium in OMI patients, especially for the viable myocardium.

关 键 词：多巴酚丁胺 超声心动图 背向散射积分 小剂量 陈旧性心肌梗死 心肌存活性 

分 类 号：R540.45[医药卫生—心血管疾病]