实时三维超声心动图评价AMI患者CABG术后左心室重构_临床医学论文.docVIP

实时三维超声心动图评价AMI患者CABG术后左心室重构_临床医学论文 实时三维超声心动图评价AMI患者CABG术后左心室重构_临床医学论文 【摘要】 目的 探讨急性心肌梗死(Acute myocardial infarction， AMI)患者冠状动脉旁路移植术(Coronary artery byass graft ， CABG )术后左心室的重构及实时三维超声心动图对其的定量评价。方法 应用实时三维超声心动图对33例急性心肌梗死患者行CABG术前、及术后1 周、1 年左室舒张末期容积、收缩末期容积、射血分数、左心室质量指数进行测量，并进行术前、术后比较分析，并与对照组进行比较。结果 手术组患者术前LVEDV、 LVESV、 LVMI 的结果较正常对照组增大(P﹤0.05)，LVEF减低(P﹤0.05)。手术组术后1 周与术前比较：LVEDV、 LVESV、LVMI的结果较术前增大(P﹥0.05)，LVEF减低(P﹥0.05)。手术组术后1年与术前比较LVEDV、 LVESV、 LVMI的结果较术前减少(P﹤0.05)，LVEF增加 (P﹤0.05)。结论 冠脉搭桥手术可逆转左室重构，实时三维超声心动图可定量对其进行评价。 【关键词】 实时三维超声;左心室重构;左心室质量 Abstract：Objective To discuss the quantitive evaluation of left ventricular remodeling in patients with AMI after CABG by using RT-3DE. Methods Data of 33 patients with AMI after CABG were acquired by using RT-3DE.The left ventricule end diastolic volume (LVEDV)，1eft ventricule end systolic volumeLV (ESV)，stroke volume (SV)，ejection fraction (EF) and mass index of 1eft ventricule were measured before CABG, one week, one year after CABG，and made comparative analysis, and compared with those of the control group as well.Results The LVEDV，LVESV and 1eft ventricular mass index (LVMI) in patients with AMI were significantly higher before CABG than those in the normal control group (0.05)，and LVEF was significantly lowered (0.05); one week after CABG, the LVEDV，LVESV and 1eft ventricular mass index (LVMI) in patients with AMI were high compared with those before CABG (P﹥0.05) and LVEF was lower (P﹥0.05); one year after CABG, the LVEDV，LVESV and 1eft ventricular mass index (LVMI) in patients with AMI were significantly lower than those before CABG (0.05)，and LVEF was significantly higher (0.05). Conclusions Coronary artery bypass grafting can reverse left ventricular remodeling, which can be quantitively evaluated by RT-3DE. 　　Key words：real-time three-dimensional echocardiography; left ventricular remodeling; left ventricular mass 　　目前在我国冠状动脉粥样硬化心脏病的发病率较高，冠心病常引起左室重构，使左室扩张、形变，在临床上引起心力衰竭，增加死亡率。冠状动脉旁路移植术可防止和改善左室重构，对临床具有重要意义。本研究应用实时三维超声心动图