关键词：经食道超声心动图；心肌组织背向散射强度记分；彩色壁运动记分；心肌存活性
【摘要】 目的 探索超声检测心肌存活的有效定量和半定量指标。方法 对24例临床确诊的亚急性及陈旧性心肌梗死病人，经食道超声进行小剂量多巴酚丁胺负荷，用IBS、CK及AQ等指标检测存活心肌。结果 ①负荷后2D运动记分减少与CK记分增加的变化，相关系数r=0.98。②负荷后AQ值变化无统计意义。③IBS曲线形态、PPI值、SD值在梗死区、正常区及梗死周围区间差别明显。负荷后梗死周围区上述值差异显著。AⅡ值在三个区域间及负荷后均无明显差异。结论 负荷后室壁节段CK记分增加≥1；该区PPI=5～10,负荷后增加12～16以上；IBS曲线由平直变成周期性峰—谷幅度明显的曲线，即应考虑此段心肌存活。
Clinical study on viable myocardium by integrated backscatter intensity of myocardium and color kinesis scores using transesophageal echocardiography
Xu Zhengxin, Zhao Xiaoyue, Wang yan. The 458th Hospital of PLA, Guangzhou 510602
【Abstract】 Objective To study quantitative and half quantitative indications for the assessment of myocardial viability with echocardiography. Methods Integrated backscatter intensity of myocardium (IBS), color kinesis (CK) scores and acoustic quantification (AQ) on transesophageal echocardiography were used for the examination of viable myocardium in 24 cases of subacute and old myocardial infarction during low dose dobutamine stress. Results ①The changes between 2D wall motion scores decrease and CK scores increase are correlated, r=0.98. ② The changes of the AQ values after stress are not significant. ③The shapes of IBS curve, PPI value and SD value among regions of infarction, normal area and perioral infarction are of significant differences, but AII is an differentiated. Conclusions After stress, wall CK scores increased by one and more; and when PPI=5～10, after stress it increased by more than 12～16, changes of the IBS curve from staight to significant peak-trough suggest viable myocardium.
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