全心尖切面心肌背向散射积分参数评价存活心肌的临床研究  

Clinical study on assessment of viable myocardium by integrated backscatter parameters in total apical views

作　　者：赵秀峰[1] 常超[1] 李东野[2] 信栓力[1] 刘丽军[1] 卢英霞[1] 牛丽杰[1] 

机构地区：[1]邯郸市第一医院心内科心血管病研究所,河北邯郸056002 [2]徐州医学院附属医院心内科,江苏徐州221002

出　　处：《吉林医药学院学报》2010年第4期195-199,共5页Journal of Jilin Medical University

摘　　要：目的探讨全心尖切面心肌背向散射积分参数评价存活心肌的临床价值。方法研究22例冠心病(CAD)患者和18例冠状动脉造影术(QCA)正常患者全心尖切面所测左室16个节段背向散射积分参数,比较CAD组中室壁运动异常节段心肌、对照组心肌的背向散射周期变异幅度(CVIB)、标化平均背向散射积分(AII%)、标化CVIB(CVIB%)值。测量CAD患者PCI术前1周内,术后2周、3月室壁运动计分指数(WMSI)、左室射血分数(EF)及IBS参数(CVIB、CVIB%及AII%),分析存活节段、坏死节段IBS参数的变化。结果 CAD组中室壁运动异常节段心肌与对照组心肌的IBS参数有显著性差异(P<0.05),PCI术后2周、3月EF、WMSI与术前相比有显著性差异(P<0.05)。存活节段与坏死节段的CVIB、AII%、CVIB%有显著性差异(P<0.05)。存活节段PCI术前IBS值与术后2周、术后3月相比,CVIB、CVIB%术后明显升高(P<0.01),而AII%显著减小(P<0.01),术后2周与术后3月相比,CVIB、AII%、CVIB%无显著性差异(P>0.05)。坏死节段的CVIB、AII%、CVIB%术前、术后2周、3月无显著性差异(P>0.05)。结论全心尖切面所测CVIB、AII%、CVIB%值能够敏感、客观地评价存活心肌。Objective To explore the clinical value of integrated backscatter in assessment of myocardial viability in total apical views.Methods Integrated backscatter parameters of 16 segments in left ventricles of twenty-two patients with coronary artery disease(group CAD) and 18 patients with normal quantitative coronary angiography(group CON) were measured,magnitude of CVIB,CVIB% and AII% were compared between the segments of abnormal wall motion in group CAD and the segments in group CON.In group CAD:WMSI,EF and IBS parameters were measured within one week of PCI,two weeks and three months after PCI to analyze the changes of IBS parameters in the viable segments and non-viable segments.Results There were significant difference between the magnitude of CVIB,AII%,CVIB% in the segments of abnormal wall motion and those in the segments of group CON.WMSI and EF were significantly different before PCI and after PCI respectively(P <0.05).The magnitude of CVIB,CVIB% and AII% were significantly different between the viable segments and non-viable segments(P <0.05).The magnitude of CVIB,CVIB% after PCI were higher than those before PCI(P <0.01).However,The magnitude of AII% of post-PCI was significantly lower than that before PCI(P <0.01),The magnitude of CVIB,CVIB% and AII% were not significantly different between PCI(2W) and PCI(3M) respectively(P >0.05).The magnitude of CVIB、AII%、CVIB% of nonviable segments were not significantly different among pre-PCI,PCI(2W),PCI(3M).Conclusion Integrated backscatter parameters in total apical views could assess viable myocardium sensitively and objectively.

关 键 词：心肌背向散射 冠状动脉疾病 冠状动脉定量造影术 存活心肌 缺血 

分 类 号：R540.4[医药卫生—心血管疾病]