组织多普勒成像定量评估心梗患者左室收缩功能的可靠性

目的　探讨DTI收缩指标的变化与心肌缺血程度的关系。方法　观察对象共 5 4人 ,观测项目为患者左室壁节段及二尖瓣环DTI s波形改变 ,并与相应的ECT指标进行了比较。结果　ECT室壁节段放射性测值心梗组非缺血区与对照组差别不显著 ,分别为 0 .76± 0 .2～ 0 .98± 0 .1与 0 .77± 0 .2～ 0 .96± 0 .1,缺血区则明显减低 0 .3 1± 0 .2～ 0 .88± 0 .2 (P<0 .0 5 )。ECT心血池显像心梗组左室射血分数为 (4 6.6± 8.9) % ,较对照组 (64 .4± 9.7) %低 (P <0 .0 5 ) ,心梗组反映左室整体功能的二尖瓣环处平均DTI s波幅为 8.4± 1.6～ 10 .5± 3 .8cm /s ,也明显低于对照组 12 .5± 2 .2～ 16.6± 4.9cm/s ,s波速度高低与ECT EF有良好的线性关系 (r =0 .67,P <0 .0 5 ) ;同时心梗组缺血节段的DTI s波速度 4.8± 0 .5～ 6.8± 1.5cm/s明显低于对照组 6.6± 1.5～ 12 .5± 3 .8cm /s(P <0 .0 5 ) ,其DTI s波幅的高低与放射性的疏密成正相关 (r =0 .68,P<0 .0 5 )。结论　如以ECT结果作为判断标准 ,DTI s波用于缺血壁段及左室收缩功能定量评价有较高的可靠性。

A Trial of Quantitatively Estimating the Left Ventricular Systolic Function in the Patients of Myocardial Infarction with Doppler Tissue Imaging

Objective To investigate the relationship between the systolic indexes of DTI and the extents of myocardial ischemia in patients with cardiac infarction. Methods Fifty-four patients were divided into cardiac infarction and control groups. In these patients, DTI systolic waves(DTI-s) of LV segments and of mitral annuli were observed, and compared with the items of ECT. Results ECT showed that the radioactions of the non-ischemic segment and the control group were from 0.76±0.2 to 0.98±0.1 and from 0.77±0.2 to 0.96±0.1 respectively, higher than the ischemic segments with the radioaction being from 0.31±0.2 to 0.88±0.2(P<0.05). The cardiac infarction group not only had a lower EF than that of the control group, with EF being (46.6±8.9)% and (64.4±9.7)% in ECT(P<0.05)respectively, but also had lower amplitudes of DTI-s at mitral annuli, ranging from 8.4±1.6cm/s to 10.5±3.8cm/s,than those of the control group, from 12.5±2.2cm/s to 16.6±4.9cm/s.The correlation between the amplitudes of DTI-s at mitral annuli and the ECT-EF was significant (r=0.67,P<0.05). The amplitudes of DTI-s in the ischemic segments were from 4.8±0.5cm/s to 6.8±1.5cm/s, much lower than from 6.6±1.5cm/s to 12.5±3.8cm/s in the control group, in which the amplitudes of DTI-s in the ischemic segments bore a positive relativity with the local radioaction (r=0.68,P<0.05). Conclusion Compared to the measurements of ECT, DTI-s could be used as a reliable indictor in quantitatively estimating the systolic function of the LV and the ischemic segments of the patients with heart infarction.