放射性核素心室造影评价前壁心肌梗死后心力衰竭患者左室整体和局部功能

摘要

目的:应用放射性核素心室造影技术对不同NYHA分级的前壁心肌梗死患者进行左室总体和局部收缩和舒张功能参数的对比分析.方法:对照组15例(G0),前壁心肌梗死NYHA 0级25例(G1),前壁心肌梗死NYHA Ⅱ～Ⅲ级12例(G2).利用平衡法门控心血池显像技术评价三组的左室总体和局部的收缩与舒张功能.结果:①左室整体收缩功能,在LVEF、PER、1/3EF、1/3ER 4个参数中,G2分别比G1和G0显著性差异(P<0.01).②左室总体舒张功能,在PFR、1/3FF、1/3FR中,G2分别比G1和G0有显著差异(P<0.01).③左室局部收缩功能,在以LVREF为参数时,G2在所有6个节段比G1和G0分别有显著下降(P<0.01).④左室局部舒张功能,在以LVR1/3FF为参数时,G2在所有6个节段比G0和G1分别有显著下降(P<0.01).结论:前壁心肌梗死后出现心功能不全或心力衰竭已对左室整体和局部的收缩及舒张功能产生损害.%Purpose: To assess left ventricular (LV) global and regional function of systolic and diastolic in the patients with anterior wall myocardial infarction,we analyzed high-temporal- resolution LV global and regional time- activity curves obtained from gated radionuclide ventriculargraphy. Methods: The patients were divided into three groups, one control group(G0) with 15 normal peoples, and two groups with patients with previous anterior wall myocardial infarction but without aneurysm, which included a first group(G1)with 25 patients in NYHA class 0, a second group(G2)with 24 patients in NYHA class Ⅱ or Ⅲ .The parameters included: (l) LV global systolic and diastolic function parameters, (2) LV regional systolic and diastolic function parameters. Results: (1)LV global systolic function: the parameters of LVEF, PER, 1/3EF, 1/3ER in G2 were reduced significantly than that in G0 and G1 (P＜0.01). (2) LV global diastolic function: the parameters of PFR 1/3FF 1/3FR in G2 were reduced significantly than that in G0 and G1 (P ＜ 0.01). (3) LV regional systolic function: the parameter of LVREF in G2 were reduced significantly in all 6 LV regional segments than that in G0 andGl(P＜0.01) .(4) LV regional distolic function: the parameter of LVR1/3FF in G2 were reduced significantly in all 6 LV regional segments than that in G0 and G1(P ＜ 0.01).Conclusion: The development of left ventricular dysfunction and heart failure after anterior wall myocardial infarction had produced damage on left ventricular global and regional function of systolic and diastolic.