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目的:采用多巴酚丁胺负荷超声心动图(DSE)试验评价心肌梗死(MI)病人冠脉重建术(CRV)后心室运动功能恢复的临床意义。方法:选择30例急性心肌梗死病人,在冠脉重建术前、术后6个月,以不同剂量多巴酚丁胺(5、10、15、20、25、30μg·kg~(-1)·min~(-1))连续静注5min后,用二维超声心动图观察患者室壁运动异常(WMA)节段的变化。结果:在不同剂量多巴酚丁胺下,CRV前后患者的心率、收缩压均呈升高反应(P<0.05),WMA均有不同程度上的改变(P<0.05)。结论:DSE试验是识别MI区域存活心肌有价值的方法之一。多巴酚丁胺从5μg·kg~(-1)·min~(-1)开始有效,10～15μg·kg~(-1)·min~(-1)达高峰,≥20μg·kg~(-1)·min~(-1)则在术前对部分病人有诱发心肌缺血,使收缩功能恶化及频发室早出现。
Objective: To evaluate the clinical significance of ventricular function recovery after coronary revascularization (CRV) in patients with myocardial infarction (MI) by dobutamine stress echocardiography (DSE). Methods: Thirty patients with acute myocardial infarction (MI) were enrolled in this study. Dobutamine (5, 10, 15, 20, 25 and 30 μg · kg -1) · Min ~ (-1)) for 5 minutes after the continuous intravenous injection, the changes of the wall motion abnormalities (WMA) were observed by two-dimensional echocardiography. Results: At different doses of dobutamine, the heart rate and systolic blood pressure of patients with CRV before and after CRV increased (P <0.05), and WMA changed to some extent (P <0.05). Conclusion: The DSE test is one of the most valuable ways to identify viable myocardium in MI area. Dobutamine started to be effective from 5μg · kg -1 · min -1 and peaked at 10 ~ 15μg · kg -1 -1min -1, -1) · min ~ (-1) preoperative myocardial ischemia in some patients, worsening of systolic function and frequent occurrence of early.