利声显心肌声学造影在冠心病介入治疗中的应用  

Clinical application of intravenous myocardial contrast echocardiography in patients undergoing percutaneous coronary interventions

作　　者：赵静[1] 张运[1] 张薇[1] 季晓平[1] 张梅[1] 李继福[1] 陈玉国[1] 钟明[1] 

机构地区：[1]山东大学齐鲁医院心内科,济南250012

出　　处：《中华超声影像学杂志》2004年第10期735-738,共4页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金资助项目 (60 0 72 0 2 2 ) ;山东大学青年基金资助项目

摘　　要：目的　探讨利声显经静脉心肌声学造影 (IMCE)在冠心病介入治疗的疗效评价及左心室功能恢复预测等方面的应用。方法　对 2 0例冠心病患者于介入治疗前后分别行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之积在治疗前后的变化。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　介入治疗后相关心肌节段的A、β及A·β均较介入前显著增加 (P <0 .0 0 1)。相关分析显示 ,随访期室壁运动记分指数与介入治疗后A、β、A·β相关良好 ( r =-0 .77,-0 .5 5 ,-0 .65 ,P <0 .0 0 1) ,其中与A相关性最好。以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可实现冠心病患者介入治疗的疗效评价 。Objective To study the clinical application of intravenous myocardial contrast echocardiography(IMCE) in assessing myocardial reperfusion by using intravenously infused Levovist before and after percutaneous coronary interventions(PCI). Methods IMCE was performed in 20 patients with coronary artery disease(CAD) before and after PCI. 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), mean ascending slope of the curve(β) and product of A·β were measured. All the patients were followed up 3 months later for assessing IMCE items of left ventricular function. Results A significant increase was showed in A,β and A·β after PCI(P<(0.001)). Good correlation existed between wall motion score index(WMSI) and A, β and A·β, while WMSI correlated best with A(r=(-0.77), P<(0.001)). The different score of A in predicting the improvement of left ventricular function showed, when A=3, the best predictive accuracy produced. Conclusions Levovist IMCE offers a simple and reliable approach to the non-invasive assessment of PCI,it can also be used to assessing the microcirculation integrity and predicting improvement of left ventricular function.

关 键 词：介入治疗 室壁运动 心肌声学造影 冠心病患者 疗效评价 治疗前后 心肌显像 测量平台 显示 检查 

分 类 号：R541.4[医药卫生—心血管疾病]