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目的:运用实时三维超声心动图(RT-3DE)检测陈旧性心肌梗死患者左室整体和节段收缩功能的改变。方法:运用RT-3DE检查25例正常人和20例陈旧性前壁心肌梗死(OMI)患者,获取左室整体和17节段容积-时间曲线,比较两组的整体和节段舒张末期容积(EDV、rEDV)、整体和节段收缩末期容积(ESVr、ESV)、整体和节段射血分数(EF、rEF)及节段-整体射血分数(rgEF)。结果:OMI组整体EDV、ESV及梗死节段rEDV、rESV较对照组增大,整体EF、梗死节段rEFr、gEF降低(P<0.05)。心尖部rEDVr、ESV增大,rEF、rgEF较对照组降低,部分非梗死节段rEF、rgEF较正常组增大(P<0.05),余节段无明显差异。结论:陈旧性前壁心肌梗死后左室整体、梗死节段及心尖部收缩功能下降,部分未梗死节段心功能代偿性增强。RT-3DE可准确定量评价心肌梗死后左室整体和局部容积及收缩功能的改变。
Objective: To detect the change of left ventricular global and segmental systolic function in patients with old myocardial infarction by real-time three-dimensional echocardiography (RT-3DE). Methods: Twenty-five normal subjects and 20 elderly patients with anterior wall myocardial infarction (OMI) were examined by RT-3DE. The volume-time curves of left ventricular and total 17 segments were obtained. The global and regional end-diastolic volumes EDV, rEDV), overall and segment end-systolic volume (ESVr, ESV), global and segmental ejection fraction (EF, rEF), and segment-total ejection fraction (rgEF). Results: The overall EDV, ESV and the rEDV and rESV in the infarct segment of OMI group were higher than those of the control group. The overall EF and rEFr and gEF of the infarct segment were decreased in the OMI group (P <0.05). REDVr and ESV increased, rEF and rgEF decreased in the apex, rEF and rgEF in some non-infarcted segments increased compared with the normal group (P <0.05), but there was no significant difference in the remaining segments. CONCLUSION: The left ventricular mass, infarction and apex systolic function decline after old anterior myocardial infarction, and some patients do not have compensatory enhancement of cardiac function. RT-3DE can accurately quantify the left ventricular global and regional volume and systolic function changes after myocardial infarction.