摘要
目的 评价急性心肌梗死后小剂量多巴酚丁胺超声心动图试验 (LDDSE) ,对梗死区存活心肌的识别价值和早期静脉溶栓的疗效。方法 对 31例Q波急性心梗患者 (其中 1 8例尿激酶溶栓治疗 )于发病后 4周行LDDSE。多巴酚丁胺按 5 μg/ (kg·min) ,持续 5分钟静脉给药 ,观察给药前后梗死区心肌室壁运动 ,计算室壁运动得分指数 (WMSI)。 1 4例 4月后随访观察室壁运动恢复情况。结果 31例急性心梗患者 496个节段 ,基础状态下发现室壁运动异常 87个节段。LDDSE发现 49个节段 (5 6 .3% )室壁运动有不同程度的改善。LDDSE后WMSI低于基础状态 (1 .1 2± 0 .1 6和 1 .2 6± 0 .1 5 ,P <0 .0 1 )。溶栓组LDDSE后WMSI明显低于基础状态 (1 .0 8± 0 .1 2和 1 .2 7± 0 .1 6 ,P <0 .0 1 ) ,溶栓组LDDSE后室壁运动明显增强者明显高于非溶栓组 (6 4.8%和 36 .4% ,P <0 .0 1 )。 4月后随访 1 4例 38个节段异常中室壁运动恢复 1 9节段 (5 0 % )。结论 提示 87个节段运动异常的心肌中有 49个节段 (5 6 .3% )具有存活性。基础状态时减弱节段的存活心肌比无运动节段更常见 (73.6 %和 35 .5 % ,P <0 .0 1 )。早期静脉溶栓治疗可明显提高梗死区的存活心肌。LDDSE对梗死区存活心肌的识别敏感、安全、可靠、易重复 ,具有重要的临床?
Objectives To evaluate low dose dobutamine stress echocardiography(LDDSE) in identification of myocardial viability in patients after acute myocardial infarction(AMI) and compare the result with the group that recieved early thrombolysis treatment.Methods Thirty-one patients with Q wave AMI after 4 weeks were involved in this study.All patients were performed LDDSE after a dose of 5 μg/(kg·min) dobutamine infusion for 5 minutes.Then,wall movement score index(WMSI) was calculated.Results In all 496 segments,wall movements in 49 segments(56.3%) were found improved and WMSI after LDDSE was significant lower than that in rest(1.12±0.16vs1.26±0.15,P<0.01).Compared with that after LDDSE,WMSI before LDDSE in thrombolysis group was also significant lower (1.08±0.12vs1.27±0.16,P<0.01).Marked improved segments in thrombolysis group was significant higher than that in the group without thrombolysis treatment(64.8%vs36.4%,P<0.01).Conclusions LDDSE is very useful in identification of myocardial viability after AMI.Early thrombolysis treatment can much improve wall movement of viable myocardium.
出处
《宁夏医学杂志》
CAS
2000年第10期585-587,共3页
Ningxia Medical Journal
关键词
心肌梗死
多巴酚丁胺
超声心动图
LDDSE
Myocardial mfarction
Dobutamine
Echocardiography
doppler color
Myocardium
thrombolytic therapy
