急性心肌梗死介入治疗后慢血流现象的血管内超声影像分析  

Intravascular ultrasound analysis of slow flow phenomenon in infarction related artery of acute myocardial infarction patients after percutaneous coronary intervention

作　　者：刘健[1] 韩雅君[2] 王伟民[1] 刘传芬[1] 卢明瑜[1] 马玉良[1] 

机构地区：[1]北京大学人民医院心内科,100044 [2]内蒙古自治区医院心内科

出　　处：《中国介入心脏病学杂志》2011年第1期20-23,共4页Chinese Journal of Interventional Cardiology

摘　　要：目的评价急性心肌梗死(AMI)患者直接介入治疗术后发生慢血流现象的梗死相关动脉(IRA)的病变特征。方法 18例AMI患者的IRA介入术前进行血管内超声(IVUS)检查,对梗死相关动脉置入冠脉支架治疗,根据TIMI帧数方法对术后血流进行评价,分成慢血流组(6例)和正常血流组(12例)。分析慢血流组和正常血流组的IRA外弹力膜-最小管腔面积(EEM-CSA)、最小管腔面积、面积狭窄、斑块负荷、平均斑块面积、斑块容积等指标。结果慢血流组EEM-CSA、平均斑块面积、斑块容积高于正常血流组,分别是(20.90±6.38)mm2比(14.87±4.50)mm2,P=0.033;(12.95±3.06)mm2比(9.21±3.35)mm2,P=0.045;(450.89±120.65)mm3比(199.08±83.53)mm3,P=0.0001。结论 AMI患者IRA介入术后慢血流与介入术前的靶病变斑块面积、斑块容量以及EEM-CSA有关,斑块面积和容量越大介入术后发生慢血流的概率越大,血管面积较大发生慢血流的概率亦较大。Objective To evaluate the lesions＇ feature of infarction related artery（IRA）with slow flow phenomenon after percutaneous coronary intervention in patients with acute myocardial infarction.Methods Preintervention intravascular ultrasound（IVUS）was performed in the infarction related arteries of 18 patients with acute myocardial infarction.Stents were implanted in all the IRAs.Coronary flow after intervention was evaluated with by means of Thrombolysis In Myocardial Infarction frame counts.They were divided into the slow flow group（n=6）and the normal flow group（n=12）.We analyzed external elastic membrane cross-sectional area（EEM-CSA）,minimum lumen diameter,area stenosis,plaque burden,average plaque area,plaque volume in IRA with IVUS.Results EEM-CSA（20.90±6.38 mm2 vs 14.87±4.50 mm2,P=0.033）average plaque area（12.95±3.06 mm2 vs 9.21±3.35 mm2,P=0.045）and plaque volume（450.89±120.65 mm3 vs 199.08±83.53 mm3,P=0.0001）in the slow flow group were higher than in the normal flow group respectively.Conclusion The slow flow of IRA after intervention was related to plaque area,plaque volume and EEM-CSA of the target lesions in patients with acute myocardial infarction.The larger were plaque area and volume,the higher rates were slow flow phenomenon after intervention.The larger the vessel area also caused higher rates of slow flow after intervention.

关 键 词：心肌梗死 动脉 血管内超声 血流速度 

分 类 号：R453.3[医药卫生—治疗学]