经胸超声心动图测定冠状动脉血流储备对冠脉狭窄的诊断价值  

The Diagnostic Value of Coronary Flow Reserve by Transthoracic Echocardiography in Patients with Coronary Stenosis

作　　者：陈中青[1] 贾绍斌[1] 房瑞祥[1] 

机构地区：[1]宁夏医科大学附属医院心脏中心,银川750004

出　　处：《宁夏医科大学学报》2009年第3期302-305,共4页Journal of Ningxia Medical University

摘　　要：目的经胸超声心动图测定冠状动脉血流储备(CFR)对冠脉狭窄的诊断价值。方法共选择117例患者。其中有胸痛但造影正常组45例;心绞痛组37例;急性心肌梗死组35例,对所有患者均进行了经胸超声心动图冠状动脉血流储备测定和选择性冠状动脉造影及造影评价。结果①三支血管显像率:前降支(LAD)为89%,左旋支(LCX)为76%,右冠脉(RCA)为82%。②心绞痛组和急性心肌梗死组冠状动脉血流储备明显低于造影正常组(P<0.01);并且心绞痛组罪犯血管CFR与管腔狭窄程度明显相关,两者呈负相关关系(r=-0.662,P<0.001);但急性心肌梗死组梗死相关动脉(IRAs)的CFR与管腔狭窄程度无明显相关性(r=-0.152,P>0.05)。结论CFR测定可协助对冠状动脉狭窄程度的判断;但微循环功能的损伤,可影响CFR对冠脉狭窄病变的评估。Objective To explore the diagnostic value of coronary flow reserve by transthoracic echocardiography in coronary stenosis. Methods 117 patients including 45 patinets with chest pain and normal angiograms（the first group）, 37 patients with angina pectoris （the second group） and 35 patients with acute myocardial infarction（ the third group） were divided into tree groups. Hemodynamic and selective angiographic measurement of all the coronary arteries were recorded successfully. Results （1）The appearance percentage was 89% in LAD, 76% in LCX and 82% in PD respectively. （2） The CFR of the second and third group were significantly lower than that of the first group （ P 〈 0.01 ）. There was a negative correlation between the CFR and percent diameter stenosis（ DS% ） in the second group（ r= -0.662, P 〈0.001 ）, but this was not existed in the third group （r = -0. 152, P 〉 0.05）. Conclusion Measuring coronary flow reserve（CFR） is contributable to the assessment of coronary stenosis . Abnormal situation of the microvascular bed can affect the assessment of the coronary stenosis by measuring CFR.

关 键 词：冠状动脉血流显像 冠脉血流储备 冠状动脉狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]