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目的:比较心脏电机械标测系统(electromechanicalmapping,NOGA)、TM核素心肌显像和超声心动图在评估急性心肌梗死患者存活心肌状况的作用。方法:选择2003-01/04南京医科大学附属南京第一医院心内科住院并符合纳入标准的急性心肌梗死患者5例,均为男性,平均年龄(56±3)岁。急诊经皮冠状动脉腔内成形术后第7天分别进行NOGATM系统、心脏超声及核素心肌显像测定。结果:NOGA系统测定出梗死区域的单极电压(unipolarvoltagepoten-TMtials,UVP)犤(5.8±2)mV犦显著低于非梗死区域的心肌犤(11.9±3)mV,P<0.01犦,同时测得梗死区域心肌的内膜下心肌短缩率(linearlocalshortening,LLS)犤(0.7±0.2)%犦明显小于非梗死区域心肌犤(11.2±4)%,P<0.01犦。特征性曲线分析NOGATM判断心肌存活状态的UVP界定值为8.0mV敏感性及特异性均为88%。()结论:LLS与心脏超声相关性良好,当UVP≥8.0mV时提示心肌处于存活状态。
OBJECTIVE: To compare the effects of electromechanical mapping (NOGA), TM radionuclide imaging and echocardiography in assessing the status of viable myocardium in patients with acute myocardial infarction. Methods: Five patients with acute myocardial infarction hospitalized in Nanjing First Hospital Affiliated to Nanjing Medical University from January to April 2003 were enrolled. All were male, mean age 56 ± 3 years. NOGATM system, echocardiography and radionuclide myocardial imaging were performed on the 7th day after emergency percutaneous transluminal coronary angioplasty. Results: The univariant voltage (5.8 ± 2) mV 梗 of unipolar voltage (UVP) 梗 (5.8 ± 2) mV 梗 of the NOGA system was significantly lower than that of the non-infarcted area (11.9 ± 3) mV, P <0.01 犦Myocardial intima showed a significantly lower myocardial Ll (0.7 ± 0.2)% linear (11.2 ± 4)% in the non-infarcted area, P <0.01 犦. Characteristic Curve Analysis NOGATM has a sensitivity and specificity of 88% for the UVP cutoff value of 8.0 mV for the determination of myocardial viability. () Conclusion: The correlation between LLS and cardiac ultrasound is good. When UVP≥8.0mV, the myocardium is in a viable state.