无创检查对冠状动脉搭桥术后疗效评价的意义  

Echocardiography analysis of ventricle wall motion combined with ^(99)mTc-MIBI gated myocardial tomography imaging for evaluating the effects of the surgery of coronary artery disease

作　　者：陈翔[1] 张向华[1] 张华[2] 姚昊[3] 魏福领[1] 

机构地区：[1]解放军第309医院心外科,北京100091 [2]解放军第309医院超声科,北京100091 [3]解放军第309医院核医学科,北京100091

出　　处：《北京医学》2009年第8期449-451,共3页Beijing Medical Journal

摘　　要：目的采用多普勒超声心动图联合ECT心肌断层显像技术等无创检查方法,评价冠心病的外科治疗效果。方法86例冠心病患者分别于冠脉搭桥(CABG)术前1周、术后4周行多普勒超声心动图和99mTc-甲氧基异丁基异腈(99mTc-MIBI)心肌断层显像检查。依据冠状动脉分布观察心脏节段室壁运动,测量左室收缩末期容积(LVESV)、舒张末期容积(LVEDV)、左室射血分数(LVEF)等参数;计算心肌灌注放射性稀缺变和稀疏面积比率。结果CABG术后4周超声心动图检查各指标与术前相比,心脏局部室壁运动异常明显改善,LVESV[(35.2±27.1)ml vs (51.7±31.4)ml]、LVEDV[(80.2±41.4)ml vs (91.3±45.4)ml]显著减低,LVEF[(58.8±9.2)% vs (45.0±8.4)%]显著增加(P均<0.01)。ECT心肌断层显像结果表明,63例(73%)心肌灌注稀缺和稀疏面积由术前的71.4%减少到54.6%,改善16.8%(P<0.01)。结论多普勒超声心动图联合ECT心肌断层显像技术是患者乐于接受的无创检查方法,对于评价CABG术后疗效有重要意义。Objective To analyze ventricle wall motion with pulsed tissue Doppler echocardiography （P-TDE） and quantitative analysis of ^99mTechnetieum-MIBI single-photo emission computed tomography（SPECT） before and after CABG in order to evaluate the effects of coronary artery bypass graft surgery （CABG）. Methods 86 cases with coronary artery disease （62 men, 24 women, mean age of 62 years old） underwent P-TDE examination before and after CABG, and the velocity parameters measured were LVESV, LVEDV, LVEF, CO, SEM and Vsem. At the same time, the rest SPECT was performed in the 86 patients. The location, degree and area of blood flow deficit were quantitively analyzed. Results Compared with results of echocardiography before CABG,tbe ventricle motion improved significantly after CABG. LVESV decreased significantly [（35.2±27.1）ml vs （51.7±31.4）ml].LVEDV was reduced from （91.3±45.4）ml to （80.2±41.4）ml. While LVEF was increased significantly[（58.8±9.2）% vs（45.0±8.4）%].^99mTc-MIBI SPECT showed there were 63 cases（73%） whose blood flow deficit area was reduced from 71.4% to 54.6% ,which improved 16.8% .Conclusions Doppler eehoeardiography combined with ^99mTc-MIBI SPECT is an acceptable and noninvasive examination,which is significant for evaluating the effects of CABG and has wide clinical value.

关 键 词：冠状动脉搭桥术 多普勒超声心动图 单光子发射计算机断层扫描 

分 类 号：R654.2[医药卫生—外科学] R730.4[医药卫生—临床医学]