Porter T R, Li S, Oster R, Deligonul U
University of Nebraska Medical Center, Omaha 68198-2265, USA.
Am J Cardiol. 1998 Nov 15;82(10):1173-7. doi: 10.1016/s0002-9149(98)00597-9.
Intravenous injections or infusions of perfluorocarbon-exposed sonicated dextrose albumin microbubbles were given 2.4 +/- 1.6 days following acute myocardial infarction to 45 consecutive patients. Patients were divided into 3 groups: patients with Thrombolysis In Myocardial Infarction (TIMI) grade 3 angiographic flow but persistent myocardial contrast defects by echocardiography (no reflow), patients with TIMI 3 flow and myocardial contrast enhancement (reflow), and patients with TIMI grade 0 to 2 flow in the infarct vessel. Thirty-five patients had TIMI 3 flow at the time of contrast study. Of these, 25 had evidence of reflow with intravenous contrast, whereas 10 (29%) still had contrast defects. At follow-up, end-systolic volume index decreased significantly in patients who exhibited reflow (21 +/- 8 ml/m2 at baseline to 18 +/- 8 ml/m2 at follow-up; p = 0.04), whereas those with no reflow had a significant increase (26 +/- 9 ml/m2 at baseline to 32 +/- 9 ml/m2 at follow-up; p = 0.006). A persistent contrast defect in the infarct zone demonstrated with intravenous ultrasound contrast following restoration of TIMI grade 3 flow in the infarct vessel identified patients likely to have deterioration in both regional and global systolic function.
在急性心肌梗死后2.4±1.6天，对45例连续患者静脉注射或输注全氟碳暴露的超声处理葡萄糖白蛋白微泡。患者分为3组：心肌梗死溶栓（TIMI）3级血管造影血流但经超声心动图检查仍有持续性心肌造影剂缺损（无再流）的患者、TIMI 3级血流且有心肌造影增强（再流）的患者以及梗死相关血管TIMI 0至2级血流的患者。35例患者在造影剂研究时TIMI 3级血流。其中，25例经静脉造影剂显示有再流证据，而10例（29%）仍有造影剂缺损。随访时，有再流的患者左室收缩末期容积指数显著降低（基线时为21±8 ml/m²，随访时为18±8 ml/m²；p = 0.04），而无再流的患者则显著增加（基线时为26±9 ml/m²，随访时为32±9 ml/m²；p = 0.006）。梗死血管TIMI 3级血流恢复后经静脉超声造影显示梗死区域存在持续性造影剂缺损，提示这些患者可能存在局部和整体收缩功能恶化。
