Objective To study the value of real‐time three‐dimensional echocardiography in evaluating overall and segmental left ventricular volume and systolic function .Methods A total of 40 patients with acute anterior myo‐cardial infarction ,50 patients with old myocardial infarction ,44 healthy volunteers (control group) were recruited as objects in this study from March 2013 to March 2014 .All the objects were performed RT‐3DE examination ,obtained segmental and overall end‐systolic volume (ESV ,rESV ) through the associated analysis software‐time curve . Results The left ventricular end diastolic diameter of acute anterior myocardial infarction ,old myocardial infarction patients were significant higher than that of the control group ,but the sEF level was significant lower than that of the control group ,the differences were all statistical significant (P<0 .05) .The overall left ventricular segmental systolic volume of acute anterior myocardial infarction ,old myocardial infarction patients were significant higher than that of the control group .Most of the whole end systolic volume of infarction segments and adjacent infarction area were hither than that of the control group .Conclusion RT‐3DE could evaluate overall and segmental left ventricular vol‐ume and syst olic function in acute and old myocardial infarction accurately .Reducing of left ventricular total and seg‐mental systolic function would impact on ventricular wall motion synchronicitily .%目的：研究实时三维超声心动图（RT‐3DE）对左心室整体和节段容积以及收缩功能的临床价值。方法选择2013年3月至2014年3月保定市第二中心医院收治的急性前壁心肌梗死患者40例、陈旧性前壁心肌梗死患者50例、同期健康志愿者44例为研究对象，所选患者均进行RT‐3DE检查，通过相关的分析软件得到节段及整体容积‐时间曲线，节段和整体收缩末期容积。结果急性前壁心梗组及陈旧性前壁心梗组患者左室舒张末内径明显高于对照组，十六节段射血分数低于对照组，两组比较差异有统计学意义（P＜0．05）。两组前壁心肌梗死患者左室整体节段收缩末期容积均大于对照组，梗死节段以及邻近梗死区域的大多数整体收缩末期容积均大于对照组。结论急性以及陈旧性心肌梗死患者的左室整体及节段舒缩功能能够运用RT‐3DE准确评价，左室整体及节段收缩功能降低会对室壁运动的同步性产生影响。
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