Grande P, Hindman N B, Saunamäki K, Prather J D, Hinohara T, Wagner G S
Am J Cardiol. 1987 Jun 1;59(15):1239-44. doi: 10.1016/0002-9149(87)90897-6.
This prospective study compares the estimated size of acute myocardial infarction (AMI) by cumulative serum creatine kinase isoenzyme MB (CK-MB), Selvester QRS score, and 2-dimensional (2-D) echocardiographic dyssynergy of the left ventricle in 63 consecutive patients with their first anterior (n = 31) or inferior AMI (n = 32). The correlations among these parameters were good for patients with anterior AMI (r = 0.74 to 0.78, standard error of the estimate = 29 to 33%) but only fair for those with inferior AMI (r = 0.35 to 0.47, standard error of the estimate = 38 to 73%). Based on previous autopsy studies, estimates of CK-MB and QRS score were then converted to percent of infarcted left ventricle. Linear regression analyses between mean percent AMI size by cumulative CK-MB plus QRS score vs the number of dyssynergic segments by 2-D echocardiography were used to develop a comprehensive formula for estimating AMI size by a combination of all 3 techniques. Thus, a formula is proposed that may optimally estimate AMI size derived from leakage of cytosolic enzymes, changes in the sequence of myocardial depolarization, and irregularities of left ventricular contraction.
这项前瞻性研究比较了63例首次发生前壁心肌梗死（n = 31）或下壁心肌梗死（n = 32）的连续患者中，通过累积血清肌酸激酶同工酶MB（CK-MB）、塞尔维斯特QRS评分以及二维（2-D）超声心动图检测左心室运动不协调来估计急性心肌梗死（AMI）面积的情况。对于前壁心肌梗死患者，这些参数之间的相关性良好（r = 0.74至0.78，估计标准误 = 29%至33%），但对于下壁心肌梗死患者，相关性一般（r = 0.35至0.47，估计标准误 = 38%至73%）。基于先前的尸检研究，随后将CK-MB和QRS评分的估计值转换为梗死左心室的百分比。通过累积CK-MB加QRS评分得出的平均AMI面积百分比与二维超声心动图显示的运动不协调节段数量之间进行线性回归分析，以建立一个综合公式，通过这三种技术的组合来估计AMI面积。因此，提出了一个公式，该公式可能最佳地估计源自细胞溶质酶泄漏、心肌去极化顺序变化以及左心室收缩不规则的AMI面积。
