CAJ | 학술논문

目的：探讨心脏核磁共振成像（CMR）对缺血后处理急性 ST 段抬高型心肌梗死（STEMI）后心室重塑的影响。方法选择32例12 h 内行缺血后处理的 STEMI 患者作为实验组及12例健康志愿者作为对照组。2组均于术后6个月行 CMR检查，测量左室心功能指标及梗死心肌面积所占百分比，并以24％为分界值，将实验组又分为无重塑组和重塑组。分析各组间的心功能参数差异，并进行受试者工作特征（ROC）分析。结果与对照组比较，无重塑组与重塑组患者的舒张末期容积（EDV）、收缩末期容积（ESV）和每搏输出量（SV）均明显增加，而射血分数（EF）、PER 和 PFR 均有不同程度的下降，其中重塑组下降的幅度更为显著。ESV 与 EDV 的增大呈线性关系；PFR、PER 和 EF 均随 EDV 的增大而呈线性下降趋势。ROC 分析结果显示，EDV、ESV、EF 和 PFR 的曲线下面积分别为0．741、0．764、0．713和0．743。结论CMR 对预测心室重塑有重要作用，其中 PFR、ESV 和 EDV 可作为独立因子预测心室重塑。
목적：탐토심장핵자공진성상（CMR）대결혈후처리급성 ST 단태고형심기경사（STEMI）후심실중소적영향。방법선택32례12 h 내행결혈후처리적 STEMI 환자작위실험조급12례건강지원자작위대조조。2조균우술후6개월행 CMR검사，측량좌실심공능지표급경사심기면적소점백분비，병이24％위분계치，장실험조우분위무중소조화중소조。분석각조간적심공능삼수차이，병진행수시자공작특정（ROC）분석。결과여대조조비교，무중소조여중소조환자적서장말기용적（EDV）、수축말기용적（ESV）화매박수출량（SV）균명현증가，이사혈분수（EF）、PER 화 PFR 균유불동정도적하강，기중중소조하강적폭도경위현저。ESV 여 EDV 적증대정선성관계；PFR、PER 화 EF 균수 EDV 적증대이정선성하강추세。ROC 분석결과현시，EDV、ESV、EF 화 PFR 적곡선하면적분별위0．741、0．764、0．713화0．743。결론CMR 대예측심실중소유중요작용，기중 PFR、ESV 화 EDV 가작위독립인자예측심실중소。
Objective To explore the influence of cardiac magnetic resonance imaging (MRI)on the ventricular remodeling after ischemic post-conditioning ST-segment elevation myocardial infarction (STEMI).Methods 32 STEMI patients treated with ischemic post-conditioning in 12 hours were designed as experimental group,and 12 healthy volunteers were designed as control group.The patients in both groups were given CMR 6 months after surgery,and the left ventricular functional in-dexes and percentage of infarction size were measured.With 24% as the limit value,the experiment group was divided into remodeling and non-remodeling groups.Differences of cardiac functional param-eters and receiver operating characteristic (ROC)were analyzed among groups.Results Compared with control group,end-diastolic volume (EDV),end-systolic volume (ESV)and stroke volume (SV)in remodeling and non-remodeling groups increased significantly,whereas ejection fraction (EF),PER and PFR decreased by varying degrees,in which the decreasing range was even more sig-nificant in remodeling group.There was a linear relationship between ESV and EDV increase,and with increasing of EDV,PFR,PER and EF showed a linear diminishing trend.ROC results revealed that the areas under the curve of EDV,ESV,EF and PFR were 0.741,0.764,0.713 and 0.743, <br> respectively.Conclusion CMR plays a key role in the prediction of ventricular remodeling,in which PFR,ESV and EDV can be used as independent factors to predict ventricular remodeling.