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目的:探讨急性心肌梗死合并室间隔穿孔的超声心动图特征。方法:本研究为回顾性队列研究，选取2016年12月至2024年1月北部战区总医院心血管内科收治的132例急性心肌梗死合并室间隔穿孔患者，男64例，女68例，年龄(67.00±8.72)岁，年龄范围为43～90岁。采用超声心动图观察患者室间隔穿孔情况、室间隔穿孔大小与血流动力学关系及心肌梗死室间隔缺损部位。结果:女性患者发病年龄[(69.34±7.75)岁]高于男性[(64.52±9.05)岁]，差异有统计学意义( P<0.05)。广泛前壁/前壁心肌梗死者110例，其中室间隔心尖部缺损型占59.1%(71/110)、前室间隔缺损型占36.4%(40/110)、后室间隔缺损型占4.5%(5/110)；下、后壁心肌梗死22例，其中室间隔心尖部缺损型占9.1%(2/22)，后室间隔缺损型占90.9%(20/22)。单孔型室间隔穿孔发生率为93.9%(124/132)，多孔型室间隔穿孔发生率为6.1%(8/132)；穿孔部位位于室间隔心尖部缺损型占71.2%(94/132)，后室间隔缺损型占19.7%(26/132)，前室间隔缺损型占9.1%(12/132)。合并室壁瘤形成率为77.3%(102/132)。10 mm≤穿孔径<15 mm患者的LVEDD[(51.36±5.25)mm]大于5 mm≤穿孔径<10 mm患者[(49.35±4.37)mm]；15 mm≤穿孔径<20 mm患者的RVD[(19.88±1.80)mm]大于5 mm≤穿孔径<10 mm患者[(17.46±2.40)mm]；10 mm≤穿孔径<15 mm患者的LVEF(0.43±0.07)小于穿孔径<5 mm患者(0.52±0.04)，差异有统计学意义( P<0.05)。 结论:超声心动图可以评价室间隔穿孔部位、数目、大小及心脏功能，且穿孔部位在一定程度上能预测冠状动脉病变部位。

Objective:To summarize the image characteristics of echocardiography on myocardial infarction combined with ventricular septal rupture.Methods:This study wass a retrospective cohort study, a total of 132 myocardial infarction patients with ventricular septal rupture treated who received in the department of Cardiovascular Medicine in the General Hospital of Northern Theater Command from December 2016 to January 2024, including 64 males and 68 females, aged(69.34±7.75) years old, ranging from 43 to 90 years old.Echocardiography was used to observe the ventricular septal perforation, the relationship between ventricular septal perforation size and hemodynamics, and the location of the ventricular septal defect in myocardial infarction.Results:The onset age of female patients[(69.34±7.75)years old]was higher than that of male patients[(64.52±9.05)years old], the difference was statistically significant( P<0.05).A total of 110 cases of extensive anterior/anterior wall myocardial infarction were found, apical defect were 59.1%(71/110), were anterior ventricular septal defect were 36.4%(40/110) and posterior ventricular septal defect were 4.5%(5/110), among 22 cases of inferior and posterior wall myocardial infarction, apical defect type was 9.1%(2/22), posterior ventricular septal defect type was 90.9%(20/22).The incidence of ventricular septal perforation in single-hole type was 93.9%(124/132), multi-hole type was 6.1%(8/132), apical ventricular septal defect was 71.2%(94/132) and posterior ventricular septal defect was 19.7%(26/132), anterior ventricular septal defect type was found in 9.1%(12/132).The incidence of ventricular aneurysm was 77.3%(102/132).LVEDD of 10 mm≤perforated<15 mm patients[(51.36±5.25)mm]was higher than 5 mm≤perforated<10 mm patients[(49.35±4.37)mm]; right ventricular dimension of 15 mm≤perforated<20 mm patients[(19.88±1.80)mm]was higher than 5 mm≤perforated<10 mm patients[(17.46±2.40)mm]; left ventricular ejection fraction of 10 mm≤perforated<15 mm patients(0.43±0.07) was lower than perforated <5 mm patients(0.52±0.04), the differences were statistically significant( P<0.05). Conclusions:Echocardiography can evaluate the ventricular septal perforation site, number, size, and cardiac function, and the perforation site can predict the coronary artery lesion site to some extent.