实时心肌声学造影评价冠心病介入治疗前后心肌灌注  

Evaluation on myocardial perfusion of coronary heart disease pereutaneous coronary intervention pre and post by the transvenous myocardial contrast echocardiography

作　　者：吴向军[1] 

机构地区：[1]滨州市人民医院心内科,256600

出　　处：《国际医药卫生导报》2011年第6期670-674,共5页International Medicine and Health Guidance News

摘　　要：目的评价冠心病（CHD）经皮冠状动脉介入治疗（PCI）前、后心肌灌注情况。方法由心血管科医师筛选出经冠状动脉造影（CAG）证实冠状动脉正常的健康者和有冠状动脉狭窄的冠心病患者共42例，对人选的冠状动脉狭窄的患者在行PCI术前、后和冠状动脉正常者进行经静脉心肌声学造影（MCE），通过心肌显影程度定量判断冠状动脉微循环灌注并记录图像，将治疗前、后及冠状动脉正常者的心肌声学造影结果进行对比分析，评价手术疗效，估计患者的预后。结果23例患者PCI术治疗后，相关心肌节段的局部所有毛细血管横截面积之和（A）;血流速度（B）、心肌的血流量（A·B）均较冠状动脉介入前显著增加；PCI术后相关心肌节段组与冠状动脉正常人心肌节段组比较，局部所有毛细血管横截面积之和（A）、血流速度（B）、心肌的血流量（A·B）仍减低；相关分析显示，随访期EF值和室壁运动记分指数较术前明显增加，并与PCI术治疗后A、B、A·B相关性好。结论经静脉心肌声学造影检查能为冠心病诊断治疗领域提供一种准确、无创评价心肌微循环的临床检测手段进一步评价经皮冠状动脉介入治疗对改善心肌梗死患者心肌组织灌注的效果。未经再灌注治疗的心肌梗死或心绞痛患者应尽早行择期PCI术，挽救梗死区的缺血心肌，改善左心室功能。Objectlve To evaluate myocardial perfusion of coronary heart disease percutaneous coronary intervention （ PCI ） pre and post.Methods 42 eases were selected by doctors in department of cardiology who are confirmed coronary artery normal subjects and have coronary artery stenosis subjects by the coronary angiography, transvenous myocardial contrast echocardiography were conducted pre and post PCI in patients with coronary artery stenosis and coronary artery normal, quantitative diagnosis of coronary microcirculation perfusion through the extent of myocardial development and record images, will be comparative analysis pre and post treatment and coronary artery normal subjects, evaluate surgical efficacy, estimate prognosis of patients. Results After PCI treatment to 23 cases, the correlation-myocardial segments to the partial cross sectional area of all the capillaries：（ A ）, blood flow velocity（ 8 ）, myocardial blood flow volume （ A·B ） all increased significantly than before the percutaneous coronary intervention; PCI postoperative correlation-myocardial segments group compared to the coronary artery normal subjects of the correlation- myocardial segments group, the partial cross sectional area of all the capillaries（ A ）, blood flow velocity （ B ）, myocardial blood flow volume（ A·B ） still all decreased, correlation analysis showed, follow-up periodEF values and wall motion score index increased significantly compared with those of preoperative and after treatment with PCI in A, B, A · B good correlation. Conclusion Transvenous myocardial contrast echocardiography examination for the diagnosis and treatment of coronary heart disease areas provide an accurate, noninvasive evaluation of myocardial microcirculation and clinical test; further evaluate the treatment of pereutaneous coronary intervention in patients with myocardial infarction to improve myocardial peffusion effectively. Those patients without repeffusion therapy and angina pectoris or myocardial infarction should be tre

关 键 词：经静脉心肌声学造影 冠心病 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]