超声血管成形术对体内动脉粥样硬化斑块疗效的研究  

The Therapeutic Efficacy of Ultrasound Angioplasty on Atherosclerotic Plaques in Vivo

作　　者：王明生[1] 胡大一[1] 卢道夫 陈方[1] 王乐丰[1] 杨明[1] 李田昌[1] 贾三庆[1] 杨新春[1] 

机构地区：[1]首都医科大学心血管病研究所,北京红十字朝阳医院心脏中心,100020 [2]德国Essen University Clinic

出　　处：《中国超声医学杂志》2000年第4期255-257,共3页Chinese Journal of Ultrasound in Medicine

基　　金：北京市科委基金!资助 (编号 :952 60 2 0 0 0

摘　　要：目的 :超声血管成形术能裂解体内外动脉粥样硬化斑块和血栓。本文研究了低频、高能超声能量对体内冠状动脉和股动脉粥样硬化斑块的疗效。方法 :入选患者 8例 ,其中急性心肌梗死 6例 ,右下肢间隙跛行 2例。左前降支闭塞 4例 ,右冠状动脉闭塞 2例 ,右下肢股动脉闭塞 2例 ,无明显血栓征象。结果 :共溶栓 48次 ,每例溶栓时间 180秒。超声溶栓后冠状动脉梗塞相关血管血流达 TIMI1级 2例 ,TIMI2级 3例 ,TIMI3级 1例 ,成功率为 17% ;2例右下肢股动脉血流达 TIMI3级 ,10 0 %成功 ,股动脉残余狭窄为 75 %。超声溶栓后行 PTCA或 PTA,均达 TIMI3级 (10 0 %成功 ) ,残余狭窄减少至 32± 14%。 1例导管折断 ,2例导丝与超声探头卡住而不能拔出 ,1例血管出现轻度撕裂 ,无恶性事件。结论 :低频高能超声能量对严重动脉粥样硬化斑块疗效不佳 ,其作用有待进一步研究 ,目前临床只能选择应用。Objective:To study the feasibility of ultrasound thrombolysis(UT)in the occluded coronary and femoral arteries.Methods:Six patients had evidence of AMI and 2 cases had right severe claudication underwent UT.Adjust PTCA after UT were performed in all patients.Results:Ultrasound induced successful reperfusion in 17% of the patients with AMI and 100% in patients with severe claudication and produced a residual stenosis of 75%;PTCA were successful in reperfusion in all patients and had a final residual stenosis of 32±14% as determined by quantitative coronary angiographic analysis.The probe disrupted in 1 patient.The probe kissed with guidewire in 2 patients.There was minor dissection in 1 patient.No severe complication and clinical side effects during UT.Conclusion:The research suggests that ultrasound thrombolysis has no good effects to atheroscerotic plaques.It only could be applied for some selective cases.

关 键 词：心肌梗死 超声 溶栓 血管成形术 动脉粥样硬化 

分 类 号：R654.3[医药卫生—外科学]