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目的：评价硝酸甘油二维超声心动图（２ＤＥ）试验对急性心肌梗塞（ＡＭＩ）区域运动异常节段收缩功能自发性改善的预测价值和安全性。方法：ＡＭＩ患者 １９例，于梗塞后５～１０天行基础２ＤＥ和硝酸甘油（ＮＴＧ）２ＤＥ试验，３月左右行２ＤＥ复查。用１６节段半定量分析法对左室各节段收缩运动和增厚情况给予分级记分。观察随诊时运动异常节段收缩功能改善情况，并将试验时捡出的存活心肌节段与此对比，计算 ＮＴＧ－２ＤＥ试验预测 ＡＭＩ运动异常节段收缩功能自发改善的准确性，并评价其安全性。结果：１９例首次ＡＭＩ ，患者１２６个异常节段中，４２个节段（３３．３％）收缩功能有自发改善。与此对比，ＮＴＧ－２ＤＥ试验预测自发改善的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为６９．０％、８４．５％、６９．０％、８４．５％和７９．４％。结论：ＡＭＩ异常节段中约３３．３％可发生功能自发性改善，Ｎ７Ｌ－２ＤＥ试验对此有较准确地预测价值。
OBJECTIVE: To evaluate the predictive value and safety of the 2DE test of nitroglycerin in the spontaneous improvement of segmental contractile function in patients with abnormal myocardial infarction in acute myocardial infarction (AMI). Methods: Nineteen AMI patients underwent baseline 2DE and NTG 2DE tests 5 to 10 days after infarction. 2DE was performed in March. The 16 segments of semi-quantitative analysis of the left ventricular segments systolic motion and thickening were graded scoring. The improvement of systolic function was observed at follow-up, and the surviving myocardium segments were compared with those obtained at the time of follow-up. The accuracy of NTG-2DE in predicting the spontaneous improvement of systolic dysfunction in AMI was evaluated and evaluated safety. Results: In the first AMI of 19 cases, 42 segments (33.3%) had spontaneous systolic function in 126 abnormal segments. In contrast, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the NTG-2DE trial to predict spontaneous improvement were 69.0%, 84.5%, 69.0%, 84.5% and 79.4%. CONCLUSIONS: About 33.3% of abnormal AMI segments can exhibit spontaneous functional improvement. The N7L-2DE test predicts this value more accurately.