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目的 :评估多巴酚丁胺负荷心电图在梗死相关区域对可逆性收缩功能障碍心肌节段的检测价值。方法 :近期Q波心肌梗死患者 4 1例 ,于血管重建术前行低剂量多巴酚丁胺 (5 μg～ 10 μg/kg/min)超声心动图和负荷心电图检查 ,术后 2个月重复静息超声心动图检查。在病理性Q波导联上分析一过性ST T改变与局部收缩储备的关系。结果 :行低剂量多巴酚丁胺试验时 ,在梗死相关区域有 2 0例患者室壁运动改善 ,发生ST段抬高及T波假正常化患者较无ST段抬高及T波假正常化患者更易出现收缩储备 (P <0 .0 1)。血管重建术后有 2 2例患者室壁运动改善 ,ST段抬高及T波假正常化预测术后室壁运动改善的敏感性和特异性分别为 5 0 %和 95 %及6 0 %和 84 %。结论 :负荷试验中一过性ST段抬高和T波假正常化是检测梗死相关区域有无收缩储备有价值的方法。
PURPOSE: To evaluate the value of dobutamine stress electrocardiogram (ECG) in detecting myocardial segments of reversible systolic dysfunction in the infarct-related regions. Methods: Forty-one patients with Q-wave myocardial infarction were treated with low-dose dobutamine (5 μg ~ 10 μg / kg / min) echocardiography and load electrocardiogram before revascularization. Two months after the procedure, Resting echocardiography. Analyze the relationship between transient STT changes and local contractile reserve on a pathologic Q-Waveguide. Results: In the low-dose dobutamine test, 20 patients in the infarct-related area had improved wall motion. Compared with patients without ST-segment elevation and T-wave false-normalization Patients are more prone to shrinkage reserve (P <0 01). The sensitivity and specificity of improved wall motion, ST segment elevation and T-wave pseudo-normalization in predicting postoperative wall motion improved after revascularization were 50% and 95% and 60%, respectively 84%. CONCLUSIONS: A transient ST-segment elevation and T-wave falsification normalization in stress tests is valuable in detecting the presence or absence of contractile reserve in the infarct-related area.