本文選題：心肌梗死 + 急性病　； 參考：《中國醫(yī)學影像學雜志》2017年05期

【摘要】：目的探討急診經(jīng)皮冠狀動脈介入術(PPCI)后心肌微循環(huán)灌注水平對心肌收縮功能恢復程度的預測價值,以早期發(fā)現(xiàn)心肌無復流,改善患者不良預后。資料與方法選取49例接受PPCI治療的急性心肌梗死(AMI)患者為研究對象,術后1周內行二維應變成像(2DS)、靜息定性心肌聲學造影(MCE)檢查,術后3個月復查2DS。應用2DS測量各節(jié)段心肌收縮期縱向峰值應變(LPSS),并根據(jù)LPSS牛眼圖彩色編碼將左心室心肌分為收縮功能正常(紅色)、收縮功能受損(淺紅色、藍色)心肌。應用MCE目測半定量法對各節(jié)段心肌進行灌注評分(MPS),并根據(jù)MPS將收縮功能受損心肌分為灌注良好、灌注減少、灌注缺失心肌。比較各灌注水平間△LPSS(3個月各節(jié)段心肌LPSS與術后1周的差值),同時將MPS分別與術后1周、術后3個月LPSS行相關性分析。結果△LPSS的組間比較為灌注良好心肌灌注減少心肌灌注缺失心肌[(-5.78±6.23)%比(-4.37±6.60)%比(-1.21±4.77)%,P0.05];PPCI術后1周心肌MPS與術后1周、術后3個月LPSS均呈正相關(r=0.47、0.58,P0.001);2名評估者對心肌灌注評分一致性較好(Kappa=0.785,P0.05)。結論 AMI患者PPCI術后心肌灌注水平與心肌收縮功能相關,可預測心肌收縮功能恢復程度。
[Abstract]:Objective to explore the predictive value of myocardial microcirculation perfusion level after percutaneous coronary intervention (PPCI) on the degree of myocardial contractile function recovery, in order to find no reflow of myocardium early and improve the poor prognosis of the patients. Data and methods selected 49 patients with acute myocardial infarction (AMI) treated with PPCI as the research object and two dimensional two weeks after operation. Strain imaging (2DS), resting qualitative myocardial contrast echocardiography (MCE) examination, 3 months after operation, 2DS. application 2DS measured the longitudinal peak systolic peak strain (LPSS) of each segment of the myocardium, and divided the left ventricular myocardium into normal systolic function (red), contractile function (light red, blue) myocardium based on the color coding of LPSS bull's eye. Semi quantitative MCE visual measurement was used. Myocardial perfusion score (MPS) was performed on each segment of the myocardium, and the systolic function damaged myocardium was divided into good perfusion, decreased perfusion and perfusion missing myocardium, and the difference between LPSS and 1 weeks after the operation was compared between the 3 months of perfusion level and the correlation between MPS and 1 weeks after the operation and 3 months after the operation was analyzed. The result was Delta LPSS. The myocardial perfusion of good perfusion was compared with that of myocardial perfusion loss (-5.78 + 6.60)% ratio (-4.37 + 6.60)% (-1.21 + 4.77)% (-1.21 + 4.77)%, P0.05]. 1 weeks after PPCI, myocardial MPS was positively correlated with LPSS after operation (r=0.47,0.58, P0.001) 3 months after operation (r=0.47,0.58, P0.001); 2 assessors had better consistency of myocardial perfusion score (Kappa=0.785, P0.05). Conclusion AMI The level of myocardial perfusion after PPCI is related to myocardial contractility, and it can predict the degree of myocardial systolic function recovery.
【作者單位】： 中山大學附屬佛山市第一人民醫(yī)院超聲診療中心;
【基金】：廣東省科技計劃項目(2013B021800034)
【分類號】：R540.45;R542.22

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