冠心病患者冠脉血流储备变化的临床意义  

Coronary Blood Reserve in Patients with Coronarv Heart Disease

作　　者：林金秀[1] 陈达光[1] 陈济添[1] 林赛榕[1] 曾开淇[1] 

机构地区：[1]福建医学院附属第一医院

出　　处：《中国超声医学杂志》1994年第6期4-8,共5页Chinese Journal of Ultrasound in Medicine

基　　金：中国国家自然科学基金

摘　　要：用食管多普勒超声心动图研究２０例正常人，３７例冠心病患者的冠脉血流储备（ＣＦＲ）。在左冠状动脉主于分枝处用脉冲多普勒测定舒张期最大血流速度（ＰＤＶ）和收缩期最大血流速度（ＰＳＶ）。以潘生丁静注后和静息时的ＰＤＶ比率（Ｄ／ＲＰＤＶ）和ＰＳＶ比率（Ｄ／ＲＰＳＶ）作为ＣＦＲ指标（Ｉｌｉｃｅｔｏ氏法）。结果发现冠心病患者Ｄ／ＲＰＤＶ，Ｄ／ＲＰＳＶ分别为１．５６±０．４１，１．４３±０．３０较正常人２．５９±０．７０，２．３８±０．５８明显减少（Ｐ＜０．０１），冠心病患者３２／３７（８６．５％）例Ｄ／ＲＰＤＶ，Ｄ／ＲＰＳＶ＜２．０，正常人仅１／２０（５％）例＜２．０；ＣＦＲ下降对冠心病的检出率除了运动ＳＰＥＣＴ心肌断层显像外均较其它无创检查法高。这些资料表明：经食管多普勒超声心动图可检出冠心病患者的ＣＦＲ有明显减退，ＣＦＲ下降可作为检出冠心病的一种无创性敏感检查方法。Coronary blood flow reserve(CFR)of normal subjects(NS,n=20)、coronary heart dis-ease(CHD,n=37)were investigated with transesophageal Doppler echocardiography(TEE)technique(Iliceto’s method).Maximal diastolic velocitv(PDV)and maximal systolic velocity (PSV were calculated by pulsed wave Doppler exploration. The ratio of dipyridamole to rest maximal diastolic velocity(D/R PDV)and dipyridamole to rexst maximal systolic veIocity(D/R PSV) were considered as index of coronary blood flow reserve. It was found that D/R PDV and D/R PSV were significantly less in CHD versus NS(D/R PDV,1.56±0.41 versus 2. 59±0.70;D/R PSV,1 43±0.30 versus 2.38±0.58).32 of 37 CHD patients with D/R PDV and D/R PSV were less than 2.0 comoared to 1 in 20 normal subjects. Imparied CFR was more sensitive to detect coronary heart disease than dipyridamole test,Holter,exercise ECC, Rest- ing-SPECT. These data show that imparied CFR of coronary heart disease patients could be estimated by non-invtisive TEE;Imparied CFR is simple for detecting coronary heat disease.

关 键 词：冠心病 冠脉血流储备 血管扩张剂 

分 类 号：R541.402[医药卫生—心血管疾病]