超声心动图观察高原右心室急性心肌梗死溶栓治疗效果(PDF)
《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]
- 期数:
- 2005年第5期
- 页码:
- 473-475
- 栏目:
- 临床研究
- 出版日期:
- 2005-10-05
文章信息/Info
- Title:
- Application of Doppler echocardiography in the examination of the thrombolytic effects on highaltitude right ventricular acute myocardial infarction
- Author(s):
- ZHU Yongsheng1; ZHOU Xiaodong1; CHEN Dingzhang1; ZHANG Zeying2; ZHAO Qijun2
- Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi 710032, China
- Keywords:
- right ventricle; myocardial infarction; thrombolysis; echocardiography
- 分类号:
- R816 ;R542，22
- DOI:
- -
- 文献标识码:
- A
- 摘要:
- 目的 探讨超声心动图诊断高原地区右心室心肌梗死和判断溶栓治疗效果的价值。方法 高原地区(西藏日喀则，海拔3890 m)右心室心肌梗死患者23例，在溶栓治疗前和治疗后2~3 h进行床旁经胸超声心动图检查，10 d后再次随访。结果 溶栓治疗前后超声心动图测值比较，差异有显著性意义。 右心室前后径由30.9±2.1 mm减小至22.8±2.6 mm (P<0.01)，三尖瓣反流速度由2.96±0.32 m/s减低至1.95±0.40 m/s，反流量由3.9±0.5 ml减少至1.6±0.4 ml，房间隔和室间隔的运动分析显示大部分恢复正常。结论 急性心肌梗死时出现右心系统异常，包括严重的三尖瓣反流和房室间隔运动异常,提示超声心动图对诊断右心室心肌梗死及评判溶栓治疗的效果有重要价值。
- Abstract:
- AIM To evaluate the echocardiography in diagnosis and thrombolytic therapy of highaltitude right ventricular (RV) infarction. METHODS Twenty three patients with RV acute myocardial infarcfion at the altitude of 3890 m above sea level were enolled in the study. Transthoracic Doppler echocardiography bedside was performed bedside on the patients before, 2 to 3 hours and 10 d after thrombolysis therapy. RESULTS Significant differences were found in echocardiographic findings after the thrombolytic therapy: the right ventricular diameter was decreased from (30.9±2.1)mm to (22.8±2.6)mm (P<0.01), tricuspid regurgitant flow peak velocity was reduced from (2.96±0.32)m/s to (1.95±0.40) m/s.and the volume of tricuspid regurgitation was reduced from (3.9±0.5) ml to (1.6±0.4) ml. The interatrial septal motion and interventricular septal motion recovered in many patients. CONCLUSION The detection of a severe tricuspid regurgitation and an abnormal septal motion by echocardiography suggests that echocardiography is helpful in examining the effect of thrombolyctic therapy for RV dysfunction.
参考文献/References
［1］ LopezSendon J, ComaCanella I, Gamallo C. Sensitivity and specificity of hemodynamic criteria in the diagnosis of acute right ventricular infarction［J］. Circulation， 1984,64:515-520
［2］ Feigenbaum H. Echocardiography［M］. 5th Ed. Philadephia: Lea & Febiger, 1994.134-138.
［3］ 冯惠玲. 正常右胸导联心电图［J］. 陕西肿瘤医学, 2001,12:15-17
［4］ Zehender M, Kasper W, Kauder E, et al. Eligibility for and benefit of thrombolytic therapy in inferior myocardial infarction: Focus on the prognostic importance of right ventricular infarction［J］. J Am Coll Cardiol, 1994,24:362-366
［5］ Mattioli AV, Fini M, Mattioli G.Right ventricular dysfunction after thrombolysis in patients with right ventricular infarction［J］. J Am Soc Echocardiogr, 2000,13:655-660.
备注/Memo
- 备注/Memo:
- 收稿日期：2004-09-24.
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更新日期/Last Update: 2010-01-05