CAJ | 학술논문

目的探讨首次急性心肌梗死(AMI)患者出院前二维超声心动图检查对长期预后危险度分层的价值.方法 281例首次AMI患者出院前常规进行二维彩色超声心动图检查,并对患者进行2～10年随访,平均随访5.5年.结果 281例患者有室壁运动异常者152例(54.1%),其中室壁瘤49例,无室壁瘤的室壁运动异常者103例.室壁运动正常者为127例.患者出院后发生再梗死78例,充血性心衰64例,心源性死亡31例.室壁瘤组患者长期预后发生再梗死26例,充血性心衰23例,心源性死亡9例.该组患者的预后明显较有无室壁瘤的室壁运动异常组和室壁运动正常者组更差,差异具有统计学意义.结论严重室壁运动异常(室壁瘤)是影响AMI长期预后主要因素.出院前二维超声心动图检查对AMI长期预后危险分层具有实际意义.
목적 탐토수차급성심기경사(AMI)환자출원전이유초성심동도검사대장기예후위험도분층적개치.방법 281례수차AMI환자출원전상규진행이유채색초성심동도검사,병대환자진행2～10년수방,평균수방5.5년.결과 281례환자유실벽운동이상자152례(54.1%),기중실벽류49례,무실벽류적실벽운동이상자103례.실벽운동정상자위127례.환자출원후발생재경사78례,충혈성심쇠64례,심원성사망31례.실벽류조환자장기예후발생재경사26례,충혈성심쇠23례,심원성사망9례.해조환자적예후명현교유무실벽류적실벽운동이상조화실벽운동정상자조경차,차이구유통계학의의.결론 엄중실벽운동이상(실벽류)시영향AMI장기예후주요인소.출원전이유초성심동도검사대AMI장기예후위험분층구유실제의의.
Objective To explore the prognosis of ventricular aneurysm in first acute myocardial infarction patients by predischarge hospital echocardiogram.Methods Prospective predischarge hospital two dimensional colour flow echocardiography examination were performed in 281 first acute myocradial infarction patients.Mean followup was 5.5 years(range 2 to 10 years).Results One hundred and fifty-two(54.1%)first acute myocardial infarction patients had abnormal ventricular wall motion.Among them,49 patients had ventricular aneurysm, 103 had abnormal ventricular wall motion but without ventricular aneurysm.After discharge,78 patients had recurrent myocardial infarction, 64 had congestive heart failure,and 31 had cardiogenic death.In aneurysm group, 26 cases had recurrent MI,23 had congestive heart failure and 9 cardiogenic death.Patients with aneurysm had more cardiac events than abnormal wall motion without aneurysm group and normal wall motion group after discharge.Conclusions Abnormal ventricular wall motion is the main factor affected the prognosis of AMI.Predischarge hospital echocardiogram is meaningful to risk stratification and prognosis of AMI.