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目的探讨急性心肌梗死(AMI)患者的组织多普勒变化特征。方法以31例首次发病的AMI患者为研究对象,在发病24h内获取其标准心尖二腔、长轴、四腔二维彩色组织多普勒图像,描记心肌各节段的组织速度图(TVI)、组织位移(TT)曲线,测量基底段、中段收缩相峰值,并与40例正常人对照分析。结果前壁AMI患者的收缩期心肌运动速度峰值(Sm)和组织位移峰值(D)与正常人比较,梗死相关动脉(IRA)非完全闭塞组前壁中段和前间隔基底段、中段D下降有显著性差异(P<0.001或P<0.01);IRA完全闭塞组连同前壁基底段Sm和D减低均有显著性差异(P<0.001或P<0.01),峰值低于非完全闭塞;下壁AMI患者只有完全闭塞时下壁基底段和侧壁中段表现出减低有显著性差异(P<0.001或P<0.01、P<0.05)。AMI患者非梗死相关动脉(NIRA)的Sm和D与正常人比较,前壁AMI所有侧壁、下壁、后壁和室间隔基底段、中段的Sm和D减低均有显著性差异(P<0.001),下壁AMI只在后壁、侧壁部分节段减低有显著性差异(P<0.01)。结论前壁AMI患者的Sm和D与正常人比较能够在急性缺血早期无创、定量、准确、敏感地区分正常及缺血、坏死心肌病变程度加重,敏感性增加。在下壁AMI患者的Sm和D的差异不显著。
Objective To investigate the changes of tissue Doppler in patients with acute myocardial infarction (AMI). Methods Totally 31 AMI patients with AMI were included in this study. The standard two-dimensional color Doppler images of the apex, the long axis and the four-cavity were obtained within 24h of onset. The tissue velocity profiles (TVI) , Tissue displacement (TT) curves were measured. The basal and middle systolic phase peaks were measured and compared with 40 healthy controls. Results Compared with normal subjects, peak myocardial systolic velocity (Sm) and peak tissue displacement (D) of systolic myocardial anterior wall in patients with AMI in the anterior wall were lower in the middle and anterior basal segments of the anterior wall of infarction-related artery (IRA) There was a significant difference (P <0.001 or P <0.01) between the IRA group and the basal segment of the anterior wall (P <0.001 or P <0.01), and the peak value was lower than that of the incomplete occlusion There was a significant difference (P <0.001 or P <0.01, P <0.05) in the reduction of basal and inferior wall of the inferior wall in AMI patients with complete occlusion only. Sm and D in non-infarcted arteries (NIRA) of patients with AMI were significantly lower than those in normal subjects (P <0.001, P <0.001) in the anterior wall, inferior wall, posterior wall and basal and mid- ). The inferior wall AMI only had significant difference in the reduction of the posterior and lateral wall segments (P <0.01). Conclusions Compared with normal subjects, Sm and D in patients with AMI in the anterior wall can differentiate normal, ischemic and necrotic myocardium from noninvasive, quantitatively, accurately and sensitively in the early stage of acute ischemia. There was no significant difference in Sm and D in patients with AMI in the inferior wall.