多巴酚丁胺负荷超声对急性心肌梗死再灌注术后心肌存活性的临床研究  

Assessment of Myocardial Viability after Reperfusing Acute Myocardial Infarction with Dobutamine Stress Echocardiography

作　　者：杨俊华[1] 宋建平[1] 杨向军[1] 蒋廷波[1] 李勋[1] 王育林[1] 张健[1] 王立志[1] 刘志华[1] 

机构地区：[1]苏州大学附属第一医院心内科,江苏苏州215006

出　　处：《中国医学影像技术》2003年第12期1653-1655,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的　探讨小剂量多巴酚丁胺负荷超声 (LDDSE)早期识别存活心肌和预测其功能恢复的临床价值。方法　 2 8例急性心肌梗死患者 ,其中行直接PTCA术 18例 ,入院后第 10天进行LDDSE。结果　①LDDSE检测存活心肌的敏感性、特异性、阳性预测值和阴性预测值分别为 93 .8%、61.9%、88.2 %、76.5 %。②再灌注 <12h( 11例 )和 >12h( 7例 )的两组患者三个月时运动恢复的心肌节段分别为 85 .4%、62 .2 % ,而未行PTCA组 ( 10例 )仅为 9.1%。结论　LDDSE对急性心肌梗死患者心肌的存活性和功能恢复有较高的预测价值。Objective To evaluate the accuracy of assessing viability and functional recovery of the myocardium in acute myocardial infarction (AMI) with low-dose dobutamine stress echocardiography (LDDSE).Methods Twenty-eight patients with AMI were studied. Among them 18 cases were successfully treated with primary coronary angioplasty (TIMI Ⅱ-Ⅲ). LDDSE were performed at 10 days after hospitalization. Results ① The sensitivity, specificity, positive predictive value and negative predictive value of LDDSE in assessing the viable myocardium were 93.8%,61.9%,88.2% and 76.5%. ②The ratio of three month recovery of regional wall motion in reperfusion <12h (11 cases) and >12h (7 cases) after AMI were 85.4%, 62.2%, respectively. However, there was only 9.1% wall motion recovery in 10 cases without underwent coronary angioplasty. Conclusion LDDSE can accurately predict the recovery of dysfunctional but viable myocardium in patients with AMI.

关 键 词：多巴酚丁胺 超声心动图 急性心肌梗死 心肌存活性 再灌注 术后 

分 类 号：R542.22[医药卫生—心血管疾病] R540.45[医药卫生—内科学]