低剂量多巴酚丁胺超声心动图和心电图ST段抬高预测血管重建术后存活心肌Identification of viable myocardium by ST-segment elevation and functional improvement during low-dose dobutamine testing in Q wave myocardium infarction after revascularization
李宪伦,张小平,郑知刚,钱端,王勇,马长生,柯元南
摘要(Abstract)：
目的 采用低剂量多巴酚丁胺超声心动图 (LDDE)和负荷心电图ST段抬高评价梗塞心肌节段于血管重建术前后的存活心肌。方法 心肌梗死患者 35例 ,于术前行低剂量多巴酚丁胺超声心动图和负荷心电图检查 ,术后一个月重复基础超声心动图检查。采用 16节段和 4分法评估左室功能 ,在术前和术后随访时有 1个或 1个以上节段室壁运动评分≥ 1为功能改善。结果 35例心肌梗死患者 ,术后有 18例室壁运动改善。有 14例患者在行低剂量多巴酚丁胺试验时出现ST段抬高 ,其中术后有 11例室壁运动改善 ,ST段抬高预测术后室壁运动改善的敏感性和特异性分别为 6 1%和82 %。同样 ,在术前LDDE心肌收缩力储备阳性的 16例患者中 ,术后有 14例功能改善 ,则LDDE对术后室壁运动改善的敏感性和特异性分别为 77%和 88%。结合术前负荷试验ST段抬高和LDDE心肌收缩力储备阳性 ,对术后室壁运动改善的敏感性和特异性分别为 6 1%和 94%。结论 负荷试验ST段抬高和LDDE均是检测存活心肌安全、易行及有价值的方法
关键词(KeyWords)： ST段抬高;存活心肌;多巴酚丁胺负荷试验
基金项目(Foundation):
作者(Author): 李宪伦,张小平,郑知刚,钱端,王勇,马长生,柯元南
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