CAJ | 학술논문

目的探讨多普勒推导指数（DDI）在急性心肌梗死（AMI）患者中的系列变化及对心肌功能的预测价值。方法研究组为AMI患者48例，同时选择30例正常人作为对照组。分别在AMI发病后的24 h、1个月、6个月和12个月期间进行超声随访研究，由二尖瓣及左室流出道多普勒频谱曲线测定左室等容收缩期时间（ICT）、等容舒张期时间（IRT）及左室射血时间（ET），其多普勒推导指数采用公式：DDI＝(ICT+IRT)/ET。结果在AMI后1个月及12个月随访期间的超声指标与对照组比较，AMI组DDI值显著升高（P<0.001），而在随访期间DDI值降低（P<0.01）。在平均随访(19.8±8.8)个月期间，有5例患者出现心源性猝死，10例患者出现充血性心力衰竭，8例患者出现顽固性心绞痛，与无心脏事件的15例患者比较，其DDI值显著升高。经单变量分析DDI≥0.60、DT≤140 ms、EF≤40%、前壁心肌梗死和年龄有危险因素的预测意义（P<0.001），而多变量分析确定DDI≥0.60、DT≤140ms和年龄可作为AMI独立的预报因子(P<0.001)。结论多普勒推导指数可反映左室收缩及舒张功能状态，对于评价AMI患者预后具有重要意义。
목적탐토다보륵추도지수（DDI）재급성심기경사（AMI）환자중적계렬변화급대심기공능적예측개치。방법연구조위AMI환자48례，동시선택30례정상인작위대조조。분별재AMI발병후적24 h、1개월、6개월화12개월기간진행초성수방연구，유이첨판급좌실류출도다보륵빈보곡선측정좌실등용수축기시간（ICT）、등용서장기시간（IRT）급좌실사혈시간（ET），기다보륵추도지수채용공식：DDI＝(ICT+IRT)/ET。결과재AMI후1개월급12개월수방기간적초성지표여대조조비교，AMI조DDI치현저승고（P<0.001），이재수방기간DDI치강저（P<0.01）。재평균수방(19.8±8.8)개월기간，유5례환자출현심원성졸사，10례환자출현충혈성심력쇠갈，8례환자출현완고성심교통，여무심장사건적15례환자비교，기DDI치현저승고。경단변량분석DDI≥0.60、DT≤140 ms、EF≤40%、전벽심기경사화년령유위험인소적예측의의（P<0.001），이다변량분석학정DDI≥0.60、DT≤140ms화년령가작위AMI독립적예보인자(P<0.001)。결론다보륵추도지수가반영좌실수축급서장공능상태，대우평개AMI환자예후구유중요의의。
Objective　To analyse the serial changes and prognostic value of Doppler-derived index (DDI) in myocardial function of patients with acute myocardial infarction (AMI).Methods　DDI was measured in 48 patients with AMI and 30 normal control group by Doppler echocardiography.The patients were studied at 24 hour,on 1,6 and 12 months after AMI.DDI was defined as the sum of isovolumetric contraction time (ICT) and isovolumetric relaxation time (IRT) divided by ejection time (ET),which were measured from mitral flow and left ventricular outlow Doppler velocity profiles.Results　DDI was significantly increased at 24 hour and on 12 month (P<0.001),and decreased on 1 month and 6 month of follow-up (P<0.01) in patients with AMI than NC group.The DDI was significantly higher in 5 patients with sudden cardiac death,10 patients with developed congestive heart failure and 8 patients with refractory angina pectoris compared in 15 patients without cardiac event during (19.8±8.8) months′ follow-up.Univariate analyses showed that DDI≥0.60,EDT≤140 ms,EF≤40%,anterior wall AMI and age were significant predictors of risk.Multivariate analysis showed that DDI≥0.60,DT≤140 ms,EF≤40% and age were independent predictors of outcome.Conclusions　The DDI reflects the condition of left ventricular systolic and diastolic myocardial function ,it can be used as a reliable adjunctive index of myocardial function.