陈旧性心肌梗死患者心肌背向散射积分rn参数的临床研究

摘要

目的探讨心肌背向散射积分(IBS)参数评估陈旧性心肌梗死患者心肌病变的价值及其与局部心肌收缩功能的关系。方法应用背向散射联机分析及彩色室壁运动技术，观测21例陈旧性前间壁心肌梗死患者及27例正常人前间隔标化平均背向散射积分（%AII）、背向散射积分周期变异幅度（CVIB）、室壁增厚率（WT%）及心内膜位移速度（Vsem）。结果与正常人相比，心肌梗死患者的%AII明显增加（2.3±0.3 vs 1.6±0.2，P<0.01），CVIB明显减低（3.5±1.6 vs 7.9±1.3，P<0.01）。CVIB与反映局部心肌收缩功能的两个指标（WT%及Vsem）均呈高度相关（r分别为0.77和0.81，均P<0.01），%AII与WT%及Vse m呈一定程度相关（r分别为-0.55和-0.64,均P<0.01）。结论 %AII和CVIB可以区分正常心肌和梗死区心肌，并能反映局部心肌收缩功能，具有评估心肌存活性的潜力。%Objective　To investigate the clinical application of myocardial integrated backscatter parameters in assessment of the lesion of m yocardium and observe the relation between IBS parameters and the regional systo lic function in patients with old myocardial infarction. Methods　Two myocardial integrated backscatter parameters, the ma gnitude of cyclic variation in integrated backscatter (CVIB) and the calibrated average image intensity (%AII), were measured in 27 normal subjects and 21 patie nts with old anteroseptal myocardial infarction. Before IBS studies, all subject s were examined with conventional two-dimensional echocardiography and color kinesics (CK) to calculate the percent systolic wall thickening (WT%) and the velocities of systolic endocardial motion (Vsem). Results　%AII was higher and CVIB was lower in the infarct se ptum compared with the septum of normal subjects. CVIB correlated closely with WT% a nd Vsem (r=0.77 and 0.81,P<0.01), and there was a correlatio n between %AII and WT%, Vsem (r=-0.55 and -0.64,P<0.01). Conclusions　Both %AII and CVIB were considered to be useful to a ssess myocardial fibrosis and be valuable in the assessment of the regional syst olic function. These IBS parameters maybe reflect the myocardial viability.