目的: 应用心肌声学造影(MCE)、左心腔声学造影(LVO)联合二维斑点追踪技术(2D-STI)评价急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后心肌灌注及左心室收缩功能的变化。方法: 选取接受PCI治疗的AMI患者37例,设为观察组;同期行心脏超声检查结果示正常者30例,设为对照组。对照组及观察组于PCI术后1周行MCE、LVO、2D-STI检查,并于1个月后复查。对比观察组与对照组MCE各参数、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室射血分数(LVEF)及左心室整体纵向应变(GLS),并对观察组及对照组MCE各参数、GLS与LVEF的相关性进行分析。结果: 观察组术后1个月较术后1周曲线平台期峰值强度(A)、曲线斜率(β)及局部心肌血流量(A×β)均有提高(P＜0.05),但低于对照组(P＜0.05)。观察组术后1个月较术后1周GLS、LVEF有所提高(P＜0.05),但低于对照组(P＜0.05);LVEDV、LVESV有所降低(P＜0.05),但高于对照组(P＜0.05)。观察组与对照组MCE各参数、GLS与LVEF均存在相关性。结论: MCE、LVO联合2D-STI可以定量评价AMI患者PCI术后心肌灌注及左心室收缩功能,为PCI术后疗效评估提供可靠参考。

Objective: To evaluate the changes of myocardial perfusion and left ventricular systolic function in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) by myocardial contrast echocardiography (MCE), left ventricular contrast echocardiography (LVO) combined with two-dimensional speckle tracking imaging (2D-STI). Methods: Thirty-seven patients with AMI treated by PCI were selected as the observation group. At the same time, 30 patients with normal cardiac ultrasound results were set as the control group. The control group and the observation group at 1 week after PCI were examined by MCE, LVO and 2D-STI, and reviewed after 1 month. The MCE parameters, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF) and left ventricular global longitudinal strain (GLS) were compared between the observation group and the control group, and the correlation between MCE parameters, GLS and LVEF in the observation group and the control group was analyzed. Results: The peak intensity (A), curve slope (β) and regional myocardial blood flow (A×β) of the observation group at 1 month after operation were higher than those at 1 week after operation (P＜0.05), but lower than those of the control group (P＜0.05). The GLS and LVEF of the observation group at 1 month after operation were higher than those at 1 week after operation (P＜0.05), but lower than those of the control group (P＜0.05). LVEDV and LVESV decreased (P＜0.05), but higher than those in the control group (P＜0.05). There was a correlation between MCE parameters, GLS and LVEF in the observation group and the control group. Conclusion: MCE, LVO combined with 2D-STI can quantitatively evaluate myocardial perfusion and left ventricular systolic function in patients with AMI after PCI, and provide a reliable reference for the evaluation of curative effect after PCI.