应用心肌速度梯度评价急性心肌梗死患者可逆性左室功能障碍的临床研究  

Myocardial velocity gradient in assessment of reversible dysfunction of left ventricle in patients with acute myocardial infarction

作　　者：韩若凌[1] 王建华[1] 李英华[2] 

机构地区：[1]河北医科大学第二医院功能科,河北石家庄050000 [2]河北医科大学第四医院功能科

出　　处：《中国医学影像技术》2004年第3期408-410,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的　探讨心肌跨壁速度梯度 (MVG)评价急性心肌梗死 (AMI)患者再灌注后存活心肌的可行性及对心功能恢复的预测价值。方法　获取 2 0例AMI患者和 18例健康志愿者前间隔、下壁和后壁的中段心内、外膜侧心肌运动速度和相应室壁厚度 ,计算收缩期、舒张早期和舒张晚期的跨壁速度梯度 (MVGS、MVGE 和MVGA) ,并分析AMI患者急性期MVG改变与 2～ 5个月时心功能恢复之间的关系。结果　①AMI患者急性期梗死节段MVGS 显著低于正常对照组 ;②随访时室壁运动改善组和未改善组比较 ,急性期MVGS 降低程度后者显著大于前者 ;③以急性期MVGS 为 0或与正常值相反为区分不可逆性和可逆性节段的标准 ,MVGS 预测左室局部运动改善或恢复的敏感性为 89.1% ,特异性为 75 .0 % ,准确性为 81.8%。结论　MVG可准确定量评价左室局部运动 ,有望作为临床评价AMI患者存活心肌、预测可逆性左心功能障碍恢复的新指标。Objective To determine the value of myocardial velocity gradient (MVG) of infarct regions in evaluating myocardial viability and predicting functional recovery of left ventricle (LV) in patients with acute myocardial infarction (AMI). Methods We studied 18 healthy volunteers (control group) and 20 patients with acute myocardial infarction (AMI group). The systolic MVG (MVG S), early diastolic MVG (MVG E) and later diastolic MVG (MVG A) were calculated, and the changes of the parameters and their relation with the functional improvement of LV were analyzed. Results ①MVG S at infarct segments was significantly decreased in the patients with AMI compared with control group. ②The decreased extent of MVG S was different in patients with improvement of segmental wall motion compared with those without improvement. ③Taking MVG S equal to zero or contrary to normal within 1 week after revascularization as the diagnostic criterion for irreversible segments, the sensitivity, specificity and accuracy for prediction of LV regional functional recovery were 89.1%, 75.0% and 81.8% respectively. Conclusion As a useful index for quantitative evaluation of LV regional function, MVG may be used as a new parameter for evaluation of myocardial viability and the prediction of the recovery of regional myocardial dysfunction.

关 键 词：心肌梗塞 心肌速度梯度 心室功能障碍 左 

分 类 号：R542.22[医药卫生—心血管疾病] R445.1[医药卫生—内科学]