多巴酚丁胺超声心动图检测存活心肌与左室功能关系的研究

目的：探讨国人应用Ｄｏｂ－２ＤＥ识别存活心肌的适宜剂量并评价心肌梗死（ＭＩ）患者存活心肌与左室整体功能状态 之间的关系。方法：多巴酚丁胺（Ｄｏｂ）连续静脉注射的同时，应用二维超声心动图（２ＤＥ）及脉冲多普勒超声心动图 ＰＤＥ）观察ＭＩ区域内室壁运动有无改善及主动脉瓣口、二尖瓣口血流动力学指标。结果：随着Ｄｏｂ剂量的增加，存活 心肌检出率增加，而不良反应发生率也增加；存活心肌（ＶＭ）组的ＡＯＰＫ、ＡＣＣ、ＳＶＩ、ＳＶ、ＣＯ值的变化率明显大于无存活心 肌组；ＶＭ组的ＩＶＲＴ及ＩＶＩＴｃ用药后明显缩短。结论： ７．５μｇ／ｋｇ·ｍｉｎ的Ｄｏｂ是国人评价存活心肌的适宜剂量；多普勒血 流频谱指标可作为评价心肌梗塞区域收缩储备能力及心室整体功能状态的重要参考指标。

The study of dobutamine echocardiography for detecting the relation of viable myocardium and left ventricular function

Objective: To seek an optimal dose of Dobutamine(Dob)for detecting viable myocardium with two-dimensional e-chocardiography(2DE) test in Chinese,and to assess the relation of viable myocardium and left ventricular function in patientswith myocardial infarction. Methods: During Dob was infused, the 2DE images and the blood flow of aorta valve and mitralvalve were recorded. Results: The change rates of AOPK, ACC,SVI, SV, CO in viable myocardium(VM) group showed agreater increase compared with those in nonviable myocardium (NM) group. The isovolumic relaxation time (IVRT) and therate-corrected IVRT(IVRTc) at peak Dob infusion shortend significantly more in VM group than in NM group. Conclusion:The optimal dose in detecting VM for Chinese is 7.5μg/kg·min. The Doppler parameters are useful means in evaluating my-ocardial contractile reserve in infarct zone and global left ventricular function.