RT-3DE评价急性心肌梗死患者左心室局部功能变化的价值分析

摘要

目的:探讨应用实时三维心脏彩超(RT-3DE)评价急性心肌梗死(AMI)患者经皮冠状动脉介入术(PCI)治疗前后左心室局部功能变化的作用.方法:选择PCI治疗的AMI患者21例为PCI组,选择相同年龄段慢性稳定性冠心病患者和健康体检者各20例,作为冠心病组和对照组.比较3组治疗前、后RT-3DE时间-容积曲线、左心室整体和局部功能指标的差异.结果:PCI组术前时间-容积形态最为不规则,术后原有紊乱节段改善明显.PCI组术前左室舒张末容积(LVEDV)和左室收缩末容积(LVESV)显著高于对照组和冠心病组,左室射血分数(LVEF)显著低于对照组和冠心病组,PCI术后上述指标均得到明显改善.PCI组左室前壁和前间壁的术前局部舒张末容积(REDV)和局部收缩末容积(RESV)显著高于对照组和冠心病组,局部射血分数(REF)和局部整体射血分数(RGEF)显著低于对照组和冠心病组,术后上述指标均得到明显改善.结论:RT-3DE可以直观、细致地评价AMI患者左心室局部功能变化.%Objective: To observe the efficiency of real-time three-dimensional echocardiography(RT-3DE)evaluating the local functional change of left ventricle before and after percutaneous coronary intervention(PCI)in acute myocardial in-farction patients.Methods: Twenty-one patients with acute myocardial infarction undergoing PCI were chosen as PCI group,and 20 cases of stable coronary artery disease and 20 health controls at the same age served as SCAD group and control group respectively.The RT-3DE time-volume curves,and global and local functional change of left ventricle were comparatively an-alyzed among the three groups.Results: The time-volume curves in PCI group before operation were most irregular.Before operation,LVEDV and LVESV were significantly increased,and LVEF was significantly decreased in PCI group as compared with those in SCAD group and control group.The RESV and REDV in both anteroseptal and anterior wall in PCI group before operation were significantly higher,and the REF and RGEF in both anteroseptal and anterior wall were significantly lower than in SCAD group and control group,and after PCI.The obvious improvement of global and local functions after PCI in PCI group was observed by RT-3DE.Conclusions: RT-3DE can intuitively and meticulously evaluate the local functional change in left ventricle of acute myocardial infarction patients before and after PCI.