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目的研究心肌组织二次谐波成像背向散射积分(IBS)用于临床诊断心肌梗死超急性期的价值。方法选择30例正常人、12例心肌梗死超急性期患者(梗死时间在2h以内)、36例典型急性心肌梗死患者(梗死时间在2~12h,有典型的心电图改变),应用超声于胸骨旁左室乳头肌短轴观,分别测量心肌梗死区域组织和非梗死区域心肌组织的IBS,并将其与心包IBS的比值作为心肌IBS的校正值(IB%),舒张末期与收缩末期的IBS差值即IBS的周期变化(CVIB),并将其与心包IBS的比值作为心肌CVIB的校正值(CVIB%)。同时记录心电图进行比较对照。结果12例心肌梗死超急性期患者心肌梗死部位的IBS值明显大于正常人(14.7对8.3,P<0.01),而CVIB明显小于正常人(6.1对7.6,P<0.05),此时心电图尚无典型变化。36例典型急性心肌梗死患者IBS明显高于正常人及患者本身非心肌梗死部位(21.3对8.3,20.2对8.5,P<0.05),而CVIB则明显低于正常人及患者本身非心肌梗死部位(5.8对7.6,5.9对9.4,P<0.05),与心电图的变化完全一致。结论心肌组织IBS对临床上判断心肌梗死超急性期有很高的特异性和敏感性,并可判断病变心肌的范围和功能状况,可作为早期诊断心肌梗死超急性期的一个可靠指标。
Objective To study the value of myocardial second harmonic imaging backscatter integration (IBS) in the clinical diagnosis of acute myocardial infarction (AMI). Methods Thirty normal subjects, 12 patients with acute myocardial infarction (infarct time within 2h), 36 patients with typical acute myocardial infarction (2 ~ 12h infarction time with typical ECG changes) were selected. Left ventricular papillary muscle short axis view, were measured myocardial infarction area and non-infarcted area of myocardial tissue IBS and its pericardial IBS ratio as the myocardial IBS correction (IB%), end-diastolic and end systolic IBS difference The value is the change in period of IBS (CVIB) and its ratio to pericardial IBS is taken as the corrected value for CVIB (CVIB%). At the same time record ECG comparison and comparison. Results The IBS of myocardial infarction in 12 patients with acute myocardial infarction were significantly higher than those in normal people (14.7 vs 8.3, P <0.01), while CVIB was significantly lower than that in normal people (6.1 vs 7.6, P <0.05) Typical changes. The IBS of 36 patients with typical acute myocardial infarction were significantly higher than those of non-myocardial infarction (21.3 vs 8.3, 20.2 vs 8.5, P <0.05), while CVIB was significantly lower than normal and patients with non-myocardial infarction 5.8 vs. 7.6, 5.9 vs. 9.4, P <0.05), exactly the same as the ECG changes. Conclusions Myocardial tissue IBS is highly specific and sensitive in judging the acute stage of myocardial infarction in clinic and can judge the extent and function of diseased myocardium. It can be used as a reliable indicator for the early diagnosis of acute myocardial infarction.