急性心肌梗死存活心肌对左室重构影响的临床研究Clinical study of the influence of infarct zone myocardial viability on left ventricular remodeling after acute myocardial infarction
葛雷,钱菊英,祝文虎,樊冰,程蕾蕾,冯琪,王灏,蔡乃绳,葛均波
摘要(Abstract)：
目的 通过小剂量多巴酚丁胺负荷超声心动图 (dobutaminestressechocardiography ,DSE)评价急性心肌梗死患者存活心肌 ,探讨存活心肌对左室重构的影响。方法 入选 5 7例首次急性前壁心肌梗死且成功进行急诊冠状动脉介入治疗的患者。心肌梗死后 72h行小剂量 [5～ 10 μg (kg·min) ]DSE评价存活心肌。所有患者在心肌梗死后 2 4h、72h、4周及 12周定期随访超声心动图。根据DSE检查结果 ,将患者分为存活心肌组 (n =36 )和无存活心肌组 (n =2 1)。结果 存活心肌组患者左室舒张末期容量指数 (LVEDVI)无明显变化 ,左室收缩末期容量指数 (LVESVI)明显降低 ;无存活心肌组患者LVEDVI和LVESVI均逐渐增加。心肌梗死后 4周及 12周 ,存活心肌组患者LVEDVI、LVESVI明显低于无存活心肌组患者 [LVEDVI:梗死后 4周为 (6 4 90± 13 5 2 )ml m2 vs (90 75± 34 92 )ml m2 ,P <0 0 1;梗死后 12周为 (6 6 82± 9 78)ml m2 vs (10 2 71± 13 0 6 )ml m2 ,P <0 0 1。LVESVI:梗死后 4周为 (2 9 6 3± 30 36 )ml m2 vs (5 4 6 2± 37 90 )ml m2 ,P <0 0 5 ;梗死后 12周为 (2 8 4 5± 12 34)ml m2 vs (5 1 35±12 5 1)ml m2 ,P <0 0 5 ]。心肌梗死后 4周及 12周 ,存活心肌组患者左室射血分数 (LVEF)明显高于无存活心
关键词(KeyWords)： 急性心肌梗死;左室重构;存活心肌;多巴酚丁胺负荷超声心动图
基金项目(Foundation):
作者(Author): 葛雷,钱菊英,祝文虎,樊冰,程蕾蕾,冯琪,王灏,蔡乃绳,葛均波
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