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目的 研究心肌组织背向散射积分 (IBS)及IBS心动周期变化幅度 (CVIB)用于临床早期诊断急性心肌梗死的价值。方法 选 30例正常人、15例急性心肌梗死患者 (心肌梗死在 2 4h以内 )、15例陈旧性心肌梗死患者 (心肌梗死在 3个月以上 ) ,应用HP 5 5 0 0型超声诊断仪 ,在胸骨旁左室乳头肌短轴切面 ,分别测量左心室前间隔、前壁、侧壁 ,后壁、下壁和后间隔心肌组织的IBS ,并将其与心包IBS的比值作为心肌IBS的校正值(IBS %) ;舒张末期与收缩末期的IBS差值即CVIB ,并将其与心包IBS的比值作为心肌CVIB的校正值(CVIB %)。同时作心电图的比较对照。结果 15例急性心肌梗死患者心肌梗死部位的IBS值明显大于非梗死部位及正常人 ( 2 1.4vs 8.1,2 1.4vs 8.2 ,均P <0 .0 0 1) ,而CVIB明显小于非梗死部位及正常人 ( 6 .5vs 10 .1,6 .5vs 7.5 ,均P <0 .0 0 1)。与心电图变化一致。陈旧性心肌梗死部位的IBS明显高于急性心肌梗死部位 ( 2 5 .6vs 2 1.4,P <0 .0 5 ) ,CVIB则明显低于急性心肌梗死部位 ( 3.9vs 6 .5 ,P <0 .0 5 )。结论 IBS对临床上诊断急性心肌梗死有很高的特异性和敏感性 ,并可判断病变心肌的范围和功能状况 ,可作为早期诊断急性心肌梗死的可靠指标。
Objective To study the value of myocardial backscatter integration (IBS) and IBIB cardiac cycle (CVIB) in the early diagnosis of acute myocardial infarction. Methods Thirty normal subjects, 15 acute myocardial infarction patients (myocardial infarction within 24 h) and 15 old myocardial infarction patients (myocardial infarction more than 3 months) were enrolled in this study. In the left paraspinal papillary muscle short axis section, the left ventricular anterior septum, the anterior wall, the anterior wall, the lateral wall, the posterior wall, the inferior wall and the posterior septal myocardial tissue IBS were measured and compared with the pericardial IBS ratio as a correction of myocardial IBS (IBS%). The difference between the end-diastolic and the end-systolic IBS was CVIB, and the ratio of CVIB to pericardial IBS was used as the CVIB of CVIB. At the same time for the ECG comparison and comparison. Results The IBS of myocardial infarction in 15 patients with acute myocardial infarction was significantly higher than that in non-infarcted and normal subjects (2 1.4 vs 8.1 and 2 2.4 vs 8.2, all P <0 01), while CVIB was significantly lower than that in non-infarcted and Normal (6.5 vs 10.1, 6.5 vs 7.5, all P <0.001). Consistent with changes in ECG. The IBS of old myocardial infarction was significantly higher than that of acute myocardial infarction (2.56 vs 2 1.4, P <0.05), and CVIB was significantly lower than that of acute myocardial infarction (3.9 vs 6.5, P <0. 0 5). Conclusions IBS has high specificity and sensitivity in diagnosing acute myocardial infarction clinically. It can also determine the extent and function of diseased myocardium and can be used as a reliable indicator of early diagnosis of acute myocardial infarction.