冠状动脉内多普勒导丝血流速度测定评价冠状动脉生理功能的研究  

Clinical Assessment of Coronary Circulation in Normal and Diseased Coronary Arteries with Intracoronary Doppler Flow Velocity Measurements

作　　者：魏盟[1] 钱菊英[1] 沈学东[1] 严卫[1] 邵志丽[1] 王齐冰[1] 樊冰[1] 潘翠珍[1] 戎卫海[1] 陈灏珠[1] 

机构地区：[1]上海医科大学中山医院

出　　处：《中国临床医学》1999年第3期200-202,共3页Chinese Journal of Clinical Medicine

基　　金：上海市医学领先专业基金!94-01-Ⅲ

摘　　要：目的：本文旨在用冠状动脉（冠脉）内多普勒血流速度描记技术观察并比较不同狭窄程度冠脉的血流速度及其储备功能的变化。方法：选择49例进行冠脉造影患者，根据造影结果分为冠脉正常组（A组）：17例患者，冠脉43支（右冠15支，前降支17支，回旋支11支）；冠脉轻、中度狭窄组（＜70％，B组）：11例患者，冠脉25支（右冠8支，前降支9支，回旋支8支）；冠脉严重狭窄组（≥70％，C组）：20例患者，冠脉22支（右冠6支，前降支13支，回旋支3支）。采用多普勒导丝分别记录各组冠脉近端和远端的平均峰值血流速度（APV），近、远端血流速度之比（P／DVR），充血相的APV及冠脉血流速度储备（CFR）。结果：A组与B组的近、远端APV均相差不大，P／DVR不高。B组近、远端APV比A组显著增加（P＜0．05），而CFR显著降低（P＜0．OS），但充血相APV及P／DVR两组无显著差别（P均＞0．05）。C组狭窄远端APV显著低于近端APV（P＜0．001），狭窄远端无显著充血相反应。其近瑞APV显著高于A组（P＜005），而于B组无显著差别（P＞0．05），其狭窄远端APV、狭窄远端充血相APV及CFR均显著低于A组及B组，P／DVR则显著高于A组和B组（P＜0．001）。结论：冠状动脉轻度狭窄者近、远血流速度比虽无显著异常，但血流速度已代偿性增加，储?objective:To Investigate and compare features of coronary blood velocity and coronary flow reserve in normal and diseased coronary arteries. Methods: Using intracoronary Doppler wire to measure proximal and distal average peak velocity (APV), ratio of proximal and distal peak velocity(P/DVR), maximal APV and coronary flow reserve(CFR) in 49 patients with normal or diseased coronary arteries. Three groups were studied. Group A with normal coronary artery, including 17 patients and 43 coronary arteries(RCA 15, LAD 17, LCX 11); Group B with intermediate lesions(<70 % ), including 11 patients and 25 coronary arteries(RCA 8, LAD 9, LCX 8); Group C with severe stenosis(≥70 % ), including 20 patients and 22 coronary arteries(RCA 6, LAD 13, LCX 3). Results: Group A and Group B got simi1ar ProVR and maximal APV (1. 15 ± 0. 33 vs 1. 17 ±0. 30 and 46. 17 ±13. 77 cm/s vs 44. 27 ± 15. 28 cm/s, respectively, P >0. 05). Baseline proximal and distal APVs in Group B were significantly higher than that in Group A(22. 27 ±7. 80cm/s vs 18. 31 ±5. 35 cm/s and 19. 89 ± 7. 64 cm/s vs 16. 80± 5. 72 cm/s, respectively, P <0.05). CFR in Group B was significantly lower than that in Group A(2. 16 ± 0. 86 vs 3. 19 ±0. 67, P <0. 05 ). In group C, distal APVs at baseline and at maximal state were significantly lower than proximal APV at baseline(14. 46 ±10. 21 cm/s and 21. 58 ±14. 22 cm/s vs 24. 13 ±14. 56 cm/s, P <0. 001 and P <0. 05, respectively). Compared with Group A and group B, the proximal APV was significantly higher than that in group A, and similar to AVP in group B(24. 13 ± 14. 56 cm/s vs 16. 80±5. 72 cm/s, P <0. 05, and VS 22. 27 ±7. 80 cm/s, P >0. 05), the distal APVs at basic state and at maximal state as well as CFR were much lower than that in Group A and group B(14. 46 ±10. 21,21. 58 ± 14. 22 cm/s, 1. 44 ± 0. 86 vs 19. 89 ± 7. 64 cm/s, 44. 27 ± 15. 28 cm/s, 2. 16 ± 0. 86 and 16. 80 ± 5. 72 cm/s, 46. 17 ±13. 77 cm/s, 3. 19 ±0. 67, respectively ,P <0. 001), however, the P/DVR was much higher than that

关 键 词：超声心动图 造影术 冠状动脉 血流储备 

分 类 号：R541.404[医药卫生—心血管疾病]