心肌声学造影在冠状动脉旁路移植术中的临床应用  

Clinical Application of Intravenous Myocardial Contrast Echocardiography in Patients Undergoing Coronary Artery Bypass Grafting

作　　者：赵静[1] 张运[1] 季晓平[1] 张薇[1] 张梅[1] 王启新[1] 李秀昌[1] 

机构地区：[1]山东大学齐鲁医院心内科,济南市250012

出　　处：《中国超声医学杂志》2004年第7期540-543,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金资助项目 (No.60 0 72 0 2 2 )

摘　　要：目的　探讨利声显经静脉心肌声学造影 (IMCE)在冠心病冠状动脉旁路移植术 (CABG)的疗效评价及左室功能恢复的预测等方面中的应用。方法　对 16例冠心病患者于 CABG前后分别行 IMCE检查 ,测量平台期的心肌显像最大强度 A、曲线上升至 A的平均斜率β及 A与β之积在手术前后的变化。随访 3个月 ,判定 IMCE各项指标预测左室功能恢复的情况。结果　手术后相关心肌节段的 A、β及 A·β均较术前显著增加 (P<0 .0 0 1)。相关分析显示 ,室壁运动记分指数 (wall molionscore index,WMSI)与 IMCE的三项测值 A、β及 A·β均有相关关系 ,其中以随访期 WMSI与术后 IMCE的 A值之间相关性为最佳 (r=- 0 .72 ,P<0 .0 0 1)。以术后 A=3分作为心肌再灌注的标准 ,对室壁运动的恢复具有较高的预测准确性。结论　利声显 IMCE提供了床旁无创评估 CABG疗效的新手段 。Objective To study the clinical applications of intravenous myocardial contrast echocardiography(IMCE) in assessing myocardial reperfusion in CAD patients using intravenously infused Levovist before and after coronary artery bypass grafting(CABG).Methods IMCE was performed in 16 CAD patients before and after CABG.The power Doppler signals of the myocardial segments were analyzed and the time-amplitude curves were plotted during Levovist infusion and incremental triggering.The maximal amplitude score(A),the mean ascending slope of the curve(β) and the product of A·β were measured.All patients were followed-up 3 months later.Results There was a significant increase in A,β and A·β after CABG(P<0.001).Good correlation was found between WMSI and A,β and A·β,while wall motion score index(WMSI) correlated best with A(r=-0.72,P<0.001).Further analyzed the different score of A in predicting the improvement of left ventricular function,A=3 was found to have the best predictive accuracy.Conclusions IMCE offers a simple and reliable approach to the non-invasive assessment of CABG,it can also be used to assess the microcirculation integrity and predict the improvement of LV function.

关 键 词：心肌声学造影 冠状动脉旁路移植术 IMCE 冠心病 

分 类 号：R445.1[医药卫生—影像医学与核医学]