CAJ | 학술논문

目的：探讨急性心肌梗死患者左室非同步运动是否可作为左室射血分数（LVEF）降低的一个独立影响因素。方法急性心肌梗死首次发作患者（梗死组）47例，经皮冠状动脉介入治疗术后2～4 d，实时三维超声心动图观测左室舒张末容积（LVEDV）、左室收缩末容积（LVESV）、LVEF及左室非同步指数（SDI）。体检健康者35例作为对照组。结果与对照组比较，梗死组LVESV、SDI增高，LVEF减低（均P＜0．01），SDI与LVEF呈负相关（r＝-0．948，P＜0．01）。多重线性回归分析，与LVEF相关的因素有体质量、心电图ST段改变、冠状动脉病变条数、LVEDV、LVESV及SDI。结论患者体质量、心电图ST段异常、冠状动脉病变条数、LVEDV、LVESV及SDI均可作为可作为评估、预测左室功能的重要指标，尤以心电图ST段异常及SDI影响较大。
목적：탐토급성심기경사환자좌실비동보운동시부가작위좌실사혈분수（LVEF）강저적일개독립영향인소。방법급성심기경사수차발작환자（경사조）47례，경피관상동맥개입치료술후2～4 d，실시삼유초성심동도관측좌실서장말용적（LVEDV）、좌실수축말용적（LVESV）、LVEF급좌실비동보지수（SDI）。체검건강자35례작위대조조。결과여대조조비교，경사조LVESV、SDI증고，LVEF감저（균P＜0．01），SDI여LVEF정부상관（r＝-0．948，P＜0．01）。다중선성회귀분석，여LVEF상관적인소유체질량、심전도ST단개변、관상동맥병변조수、LVEDV、LVESV급SDI。결론환자체질량、심전도ST단이상、관상동맥병변조수、LVEDV、LVESV급SDI균가작위가작위평고、예측좌실공능적중요지표，우이심전도ST단이상급SDI영향교대。
Objective To explore whether the left ventricular dyssynchrony in patients with acute myocardial infarction can be an independent influence factor for the decrease of left ventricular ejection fraction(LVEF). Methods Forty-seven patients with acute myocardial infarction in the first attack.Clinical manifestations,ECG,myocardial enzymes tests and coronary angiographic findings are in line with the diagnosis of acute myocardial infarction. Real-time three-dimensional echocardiography was used to observe the left ventricular systolic function and left ventricular dyssynchrony systolic of 2~4 days after PCI. Other 35 healthy volunteers of cases were used as normal control group. Results Compare with control group,SDI in acute myocardial infarction group was significantly higher(1.41%±0.40%vs. 6.54%±1.80%,P<0.01). The difference between the two groups was statistically significant.SDI and LVEF was significantly negatively correlated(r=0.948,P<0.01).Can be seen from the multiple linear regression analysis,a number of influencing factors associated with LVEF.The main factors have weight,ECG ST segment changes,coronary artery lesions,left ventricular end-diastolic volume,left ventricular end-systolic volume and SDI. Conclusion The body weight,ECG ST-segment abnormalities,number of lesions of coronary artery,left ventricular end-diastolic volume,end-systolic volume and left ventricular systolic dyssynchrony can be used as indicators for evaluating and predicting left ventricular function.