PWDTI对急性心肌梗死不同方案治疗后局部室壁运动的评估

目的应用脉冲组织多普勒成像技术(pulse-wave doppler yissue imaging,PWDTI)评价急性心肌梗死(acute myocardial infarction,AMI)不同治疗方案后局部室壁功能的变化情况。方法 AMI 患者72例,分为3组,经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)组30例,溶栓组27例,保守治疗组15例。采用PWDTI 定量测定患者治疗一周时局部室壁运动速度同时结合常规16节段超声心动图资料,并在梗死后1个月及3个月进行随访。结果 72例中共出现异常室壁运动节段382个,3组间异常室壁节段,PCI 和溶栓组在1周时收缩波峰速度(peak systolic velocity,Vs),收缩波加速度(acceleration of S wave,ACCs)及舒张早期峰速度/舒张晚期峰速度(E/A)均高于保守治疗组,在治疗后1个月到3个月时 Vs、收缩波时间速度积分(systolic velocity-timeintegral,VTIs)、ACCs 及 E/A 明显高于保守治疗组,但 PCI 组各项指标与溶栓组比较无统计学差异。结论PWDTI 评估 AMI 不同治疗对心脏局部室壁功能的影响,提示 PCI 或溶栓治疗优于保守治疗。

Evaluation of the regional wall motion change after different treatments on acute myocardial infarction by pulsed-wave tissue doppler imaging

Objective To evaluate the regional wall motion change after different therapeutic protocols in acute myocardial infarction(AMI)patients by pulsed-wave tissue doppler imaging(PWDTI).Methods Seventy-two patients were divided into three groups:percutaneous coronary intervention group(PCI,n=30),thrombolysis group(n=27)and conservative therapy group(n=15).We quantitatively measured the movement of the infarct segments with PWDTI one week,1 month and 3 months after AMI.Results There were 382 abnormal wall motion segments in 72 patients.The peak systolic velocities(Vs),systolic velocity-time integrals(VTIs), acceleration of S wave(ACCs)and the ratio e to a(E/A)were all significantly higher in PCI group and thrombolysis group than in conservative therapy group at the 1 month and 3 months after AMI.There was no significant difference between PCI group and thrombolysis group.Conclusions PCI and thrombolysis treatment can significantly improve regional wall motion compared with conservative treatment.