【摘要】 目的 探讨超声心动图诊断右心室心肌梗死和判断溶栓治疗效果的价值。方法 对68例右心室心肌梗死的患者在溶栓治疗前和治疗后2～3h进行床旁经胸超声心动图检查，10天后再次随访。结果 溶栓治疗前后超声心动图所见存在显著差异：右心室前后径由27.9±4.1mm减小至20.8±3.6mm(P<0.001)，三尖瓣返流速度由2.96±0.32m/s 减低至1.95±0.40m/s，返流量由3.9±0.5ml减少至2.6±0.4ml，房间隔和室间隔的运动分析显示大部分恢复正常。结论 急性心肌梗死时出现右心系统异常，包括严重的三尖瓣返流和房室间隔运动异常提示右心室心肌梗死，超声心动图对判断右心室心肌梗死溶栓治疗的效果有重要价值。

    【关键词】 右心室；心肌梗死；溶栓治疗；超声心动图

    【Abstract】 Objective To identify the echocardiographic findings that may help in diagnosis of right ventricular infarction and to examine the effect of thrombolyctic therapy on RV dysfunction.Methods Transthoracic Doppler echocardiography was performed in 68 consecutive patients with right ventricular infarction treated with thrombolysis. The bedside examination was performed before and 2 to 3 hours after thrombolysis therapy, and a subsequent follow-up examination was scheduled for 10 days later.Results Significant differences were found in echocardiographic findings after the thrombolytic therapy: the right ventricular diameter decreased from 27.9±4.1mm to 20.8±3.6mm (P<0.001), tricuspid regurgitant flow peak velocity was reduced from 2.96±0.32m/s to 1.95±0.40m/s. The volume of tricuspid regurgitant was reduced from 3.9±0.5ml to 2.6±0.4ml.The analyses of interatrial septal motion and interventricular septal motion showed normalization in many patients.Conclusion The presence of a severe tricuspid regurgitation and of an abnormal septal motion in patients with acute myocardial infarction indicates involvement of the right ventricle. The echocardiographic findings are helpful for examining the effect of thrombolyctic therapy on RV dysfunction. ......