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目的:探讨急性心肌梗死(AMI)患者梗死区心肌存活性对心脏功能的影响。方法:采用回顾性对比研究的方法,62例AMI患者以99mTc-MIBI SPECT静息显像及18F-FDG SPECT心肌代谢显像的检查结果分为梗死区有存活心肌组和无存活心肌组,介入治疗后随访12个月,应用超声心动图评价2组患者的心脏功能。结果:有存活心肌组左室射血分数均显著高于无存活心肌组[术前:(54.25±1.60)%∶(47.20±1.83)%,P<0.01;12个月:(58.09±1.88)%∶(50.00±2.06)%,P<0.01],有存活心肌组左室舒张末期内径均显著优于无存活心肌组[术前:(51.31±0.95)mm∶(54.33±1.07)mm,P<0.05;12个月:(51.65±1.12)mm∶(56.10±1.38)mm,P<0.05]。左房内径及舒张期二尖瓣血流速度峰值的比值2组随访时均无显著变化。结论:AMI后梗死区有存活心肌的患者心脏整体收缩功能及左室重构显著优于无存活心肌的患者,但心肌存活性对左心室舒张功能无明显影响。
Objective: To investigate the effect of myocardial viability in infarct area on cardiac function in patients with acute myocardial infarction (AMI). Methods: A retrospective comparative study was conducted in 62 AMI patients with 99mTc-MIBI SPECT resting scintigraphy and 18F-FDG SPECT myocardial metabolic imaging. The results were divided into two groups: survival myocardial infarction group and non-survival myocardial group, After 12 months of treatment, echocardiography was used to evaluate the cardiac function in the two groups. Results: The left ventricular ejection fraction in the surviving myocardium group was significantly higher than that in the non-viable myocardium group [preoperative: (54.25 ± 1.60)%: (47.20 ± 1.83)%, P <0.01; %: (50.00 ± 2.06)%, P <0.01]. The left ventricular end-diastolic diameter of the surviving myocardium group was significantly higher than that of the non-viable myocardium group [51.31 ± 0.95 mm vs 54.33 ± 1.07 mm <0.05; 12 months: (51.65 ± 1.12) mm: (56.10 ± 1.38) mm, P <0.05]. The left atrial diameter and diastolic mitral flow velocity peak ratio of the two groups had no significant change at follow-up. Conclusion: The cardiac systolic function and left ventricular remodeling in patients with viable myocardium after AMI are significantly better than those without viable myocardium. However, myocardial viability has no significant effect on left ventricular diastolic function.