CAJ | 학술논문

目的探讨心脏MRI确定的心肌梗死的梗死质量、梗死百分比、左心室功能等参数与肌酸激酶同工酶(CK-MB)峰值、肌钙蛋白T(TnT)峰值及心电图(ECG)的相关性.方法对19例首次发病3～7 d的急件心肌梗死患者行心脏MR检查.采用1.5 T MR仪行首过灌注成像及延迟强化成像.分别评价每例患者的梗死质量、梗死百分比、左心室功能,记录TnT峰值、CK-MB峰值并分析ECG.对正态分布资料行Pearson相关性检验,对非正态分布资料行Spearman相关性检验.用独立样本t检验进行2组计量资料的均数比较.结果 19例患者的梗死质量中位数为6,3 g,与左心室射血分数(LVEF)(54.1±15.4)/呈负相关(r=-0.563,P=0.012),与TnT峰值(中位数为0.8μg/L,r=0.487,P=0.0340)、左心室收缩末期容积指数(LVESVI;中位数为23.4 ml/m2,r=0.480,P=0.038)相关.梗死百分比(中位数为6.0/)分别与TnT峰值(r=0.583,P=0.009)、CK-MB峰值(中位数为43.0 U/L,r=0.470,P=0.042)、每搏输出量[LVSV;(57.6±15.0)ml,(r=-0.482,P:0.036)]相关.TnT峰值还与LVSV相关(r=-0.524,P=0.021).心肌梗死ST段抬高与非ST段抬高相比,受累段数(中位数分别为3.0和2.0,t:2.972,P=0.009)更多,TnT峰值(中位数分别为1.0和0.7μg/L,t=2.245,P=0.041)、CK-MB峰值(中位数分别为43和35 U/L,t=2.508,P=0.024)更高.结论急性期心肌梗死的梗死质最直接影响左心室功能.TnT峰值是反映梗死三百分比及左心室功能的较好指标,ST段抬高心肌梗死的范围更大.
목적 탐토심장MRI학정적심기경사적경사질량、경사백분비、좌심실공능등삼수여기산격매동공매(CK-MB)봉치、기개단백T(TnT)봉치급심전도(ECG)적상관성.방법 대19례수차발병3～7 d적급건심기경사환자행심장MR검사.채용1.5 T MR의행수과관주성상급연지강화성상.분별평개매례환자적경사질량、경사백분비、좌심실공능,기록TnT봉치、CK-MB봉치병분석ECG.대정태분포자료행Pearson상관성검험,대비정태분포자료행Spearman상관성검험.용독립양본t검험진행2조계량자료적균수비교.결과 19례환자적경사질량중위수위6,3 g,여좌심실사혈분수(LVEF)(54.1±15.4)/정부상관(r=-0.563,P=0.012),여TnT봉치(중위수위0.8μg/L,r=0.487,P=0.0340)、좌심실수축말기용적지수(LVESVI;중위수위23.4 ml/m2,r=0.480,P=0.038)상관.경사백분비(중위수위6.0/)분별여TnT봉치(r=0.583,P=0.009)、CK-MB봉치(중위수위43.0 U/L,r=0.470,P=0.042)、매박수출량[LVSV;(57.6±15.0)ml,(r=-0.482,P:0.036)]상관.TnT봉치환여LVSV상관(r=-0.524,P=0.021).심기경사ST단태고여비ST단태고상비,수루단수(중위수분별위3.0화2.0,t:2.972,P=0.009)경다,TnT봉치(중위수분별위1.0화0.7μg/L,t=2.245,P=0.041)、CK-MB봉치(중위수분별위43화35 U/L,t=2.508,P=0.024)경고.결론 급성기심기경사적경사질최직접영향좌심실공능.TnT봉치시반영경사삼백분비급좌심실공능적교호지표,ST단태고심기경사적범위경대.
Objective To determine the correlation of cardiovascular MRI with cardiac biomarkers and electrocardiography(ECG)in acute myocardial infarction(MI).Methods Nineteen patients with first acute MI were selected to undergo MRI on a 1.5 T system within 3-7 days after the onset of symptoms.A first-pass perfusion scan was performed with the administration of Gd-DTPA at a speed after cine MRI for global left ventricle(LV)funotions.Delay-enhanced MRI was performed by using an ECG-gated inversionrecovery fast-gradient echo-pulse sequence 5 to 10 minutes later with second bolus injection at a s peed.Infarct mass(IM),percentage size of infarction(PSI)and LV functions were compared with peak troponin T (peak TnT)and peak ereatine kinase-MB fraction (peak CK-MB).The 12-lead ECG was analysed for STelevation on admission.Pearson and Spearman correlation test and independent-Sample t test wel-e used for statistics.Results The IM (median 6.3 g) was correlated with peak TnT(median 0.8μg/L,r=0.487,P=0.0340)and left ventricle end-systolic volume index(LVESVI)(median 23.4 ml/m2,r=0.480,P=0.038).IM showed a negative correlation with left ventricle ejection fraction(LVEF)(54.1±15.4)/(r=-0.563.P:0.012).The PSI(median 6.0/)was correlated with peak TnT(r=0.583,P=0.009),peak CK.Mn(median 43.0 U/L,r=0.470,P=0.042)and LVSV[(57.6 ±15.0)ml,r=-0.482,P=0.036],peak TnT was also correlated with LVSV(r=-0.524,P=0.021).There were more involved segments(IS)(t=2.972,P=0.009),higher peak TnT(t=2.245,P=0.041)and peak CK-MB(t=2.508,P=0.024)in ST-elevation MI(STEMI)than in non ST-elevation MI(NSTEMI).Conclusions IM directly influences LV functions in acute MI.Peak TnT was a better biomarker reflecting PSI and LV functions.There were more involved segments in STEMI than in NSTEMI.