小剂量多巴酚丁胺负荷前后超声心动图和^(201)铊核素扫描对老年冠心病患者存活心肌的影响被引量：4

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摘要目的评价预测急性心肌梗死(AMI)早期存活心肌的201铊核素扫描(^(201)TI)心肌显像和多巴酚丁胺超声心动图的作用。方法将49例患者,平均年龄(62±10)岁在心肌梗死10 d后进行冠状动脉造影,放射性核素造影,小剂量多巴酚丁胺超声心动图,放射性核素血管造影和静息^(201)TI心肌显像。19例患者进行了血运重建(血运重建组),30例患者给予药物治疗(药物治疗组)。一年后重复静息超声心动图和核素造影,分别评价节段性功能恢复和左室射血分数(LVEF)的变化。结果血运重建组患者,108个节段运动消失或反常运动,61个节段显示功能恢复。其敏感性在^(201)TI心肌显像预测节段性功能恢复为87%,多巴酚丁胺为66%(P<0.001)而特异性和准确性分别有可比性。^(201)TI的活动度(峰值≥55%)是最佳的节段功能恢复的预测因素(P<0.001)。血运重建后LVEF改善≥5%(P<0.01)。在药物治疗组,149节段运动消失或反常运动有60节段显示功能恢复。随访8年,随访收缩储备节段大部分(94%)在多巴酚丁胺的有存活心肌在^(201)TI显像功能改善(86%)。在药物治疗组患者节段功能恢复较差或无收缩储备(38%)或无保留^(201)TI摄取(62%)。药物治疗组收缩反应是节段(P<0.001)和整体(P<0.01)左室功能改善的最好预测。结论多巴酚丁胺超声心动图可以预测心肌梗死后自行功能的恢复,而^(201)TI显像本身可识别患者心肌功能失调无收缩储备可受益于冠状动脉血运重建。

作者侍怍胜李明哲张毅刚励志洪鹿存芝张彤杨丽

机构地区徐州市中心医院心内科徐州市心血管病研究所

出处《中国老年学杂志》 CAS CSCD 北大核心 2016年第3期596-600,共5页 Chinese Journal of Gerontology

关键词收缩功能心肌存活多巴酚丁胺超声心动图 ^(201)TI显像

分类号 R541.4 [医药卫生—心血管疾病]

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