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【目的】探讨实时三维超声心动图（RT-3DE ）在冠心病急性心肌梗死患者左心室功能中的诊断价值。【方法】采用RT-3DE测量25名首发左室急性心肌梗死患者和30名正常对照者左房内径（LAD）、左室舒张末容积（LVEDV）、左室收缩末容积（LVESV）、左室整体射血分数（LVEF）、心肌梗死组及对照组节段射血分数（rEF）。【结果】与对照组比较，心肌梗死组LAD、LVEDV、LVESV较对照组增大（ P ＜0．05），LVEF较对照组减低（ P ＜0．05）；心肌梗死组125个梗死节段rEF较300个非梗死节段和对照组减低（ P ＜0．05），非梗死节段较对照组减低（ P ＞0．05）；心肌梗死组LVEF与LVEDV呈显著负相关。【结论】实时三维超声心动图能够有效的评价心肌梗死患者左室整体及节段收缩功能。“,”[Objective] To explore the value of real-time three-dimensional echocardiography (RT-3DE) in the diagno-sis of left ventricular function in patients with coronary disease and acute myocardial infarction (AMI) .[Methods]Con-ventional echocardiography was used to measure left atrial diameter (LAD ) ,left ventricular end diastolic volume (LV-EDV) ,left ventricular end systolic volume(LVESV) and left ventricular ejection fraction(LVEF) in 25 patients with first-onset AMI of left ventricle and 30 normal controls .RT-3DE was used to measure regional ejection fraction (rEF) in AMI group and control group .[Results] Compared with the control group ,LAD ,LVEDV and LVESV in AMI group in-creased(P<0 .05) and LVEF decreased( P<0 .05) .Compared with 300 non-infarction regions and control group ,rEF in 125 infarction regions of AMI group decreased ( P0 .05) .LVEF in AMI group showed significantly positive correlation with LVEDV .[Conclusion]RT-3DE can effectively evaluate global and regional left ventricular systolic function of AMI patients .