3种不同手振声学造影剂在右心声学造影中应用的对比研究  

A comparative study on hand-agitated saline solution with blood,hand-agitated 50% glucose solution and traditional hand-agitated saline solution in right heart contrast echocardiography

作　　者：冯坤 唐炯[3] 范新荣[1] 何川 黄深[2] 龙小滨[2] 范忠才 

机构地区：[1]西南医科大学附属第一医院心内科,四川泸州646000 [2]成都大学附属医院心内科 [3]成都市第三人民医院心内科

出　　处：《临床心血管病杂志》2017年第12期1175-1179,共5页Journal of Clinical Cardiology

摘　　要：目的:比较使用手振激活加血生理盐水、手振激活50%葡萄糖溶液与传统手振激活生理盐水进行右心声学造影的稳定性、有效性、敏感性、安全性,为临床选择右心声学造影剂提供参考。方法:选取2015-01-2017-08成都市第三人民医院、成都大学附属医院门诊及住院患者中怀疑有右向左分流(RLS)的患者(不明原因脑卒中、短暂性脑缺血发作、先兆性偏头痛)105例。所有患者均采用振荡20次的3种不同手振声学造影剂进行造影。记录患者右心微泡显影持续时间;观察RLS情况并进行半定量分析;监测患者造影前后的心率、血压、呼吸频率、血氧饱和度。结果:手振加血激活生理盐水、手振激活50%葡萄糖溶液较传统手振激活生理盐水空气微气泡使用时右心微泡显影持续时间长,差异有统计学意义(P<0.01),手振加血生理盐水空气微气泡较手振50%葡萄糖溶液空气微气泡右心微泡显影持续时间长,差异有统计学意义(P<0.05);手振加血激活生理盐水、手振激活50%葡萄糖溶液较传统手振激活生理盐水对于RLS检出率更高,差异有统计学意义(P<0.05),手振加血激活生理盐水与手振激活50%葡萄糖溶液对RLS检出率无统计学差异(P>0.05),但手振加血激活生理盐水对于Ⅱ、Ⅲ级分流敏感度更高,差异有统计学意义(P<0.05);所有患者造影前后心率、血压、呼吸频率、血氧饱和度差异无统计学意义(P>0.05)。结论:手振加血激活生理盐水、手振激活50%葡萄糖溶液是2种经济、安全、有效的右心声学造影剂,尤其是手振加血激活生理盐水,其造影效果较传统手振激活生理盐水更好,制备方便,值得临床推广。Objective：To compare the stability,effectiveness,sensitivity and safety of hand-agitated saline with blood,hand-agitated 50% glucose and hand-agitated saline solution,and to provide reference points in clinical examination.Method：One hundred and five inpatients or outpatients suspected of right to left shunt（RLS;including cryptogenic stroke,transient ischemic attack,migraine with aura）in the Third People＇s Hospital of Chengdu and the Affiliated Hospital of Chengdu University.All patients underwent contrast transthoracic echocardiography in which three different contrast agents had been hand-agitated for 20 times.We observed the right heart microbubbles developing time of three groups,semi-quantitatively analyzed the RLS and monitored the change of heart rate,respiratory rate,oxygen saturation.Result：The right heart microbubbles developing time of hand-agitated saline with blood and hand-agitated 50% glucose are longer than hand-agitated saline,the difference was statistically significant（P〈0.01）;the microbubbles developing time of hand-agitated saline with blood are longer than handagitated 50% glucose,the difference was statistically significant（P〈0.05）.The hand-agitated saline with blood and hand-agitated 50% glucose had a higher detection rate than hand-agitated saline,the difference was statistically significant（P〈0.05）;although the detection rate between hand-agitated saline with blood and hand-agitated 50%glucose have no statistics significance（P〈0.05）,hand-agitated saline with blood was more sensitive in detection of GradeⅡ and GradeⅢ,the difference was statistically significant（P〈0.05）.All patient＇s change of heart rate,respiratory rate and oxygen saturation had no statistics significance（P〈0.05）.Conclusion：Hand-agitated saline with blood and hand-agitated 50% glucose are two cost-effective,safe,effective right heart contrast agents.Especially,the contrast effect of hand-agitated saline with blood is better than traditional hand-agitated saline.Hand-

关 键 词：声学造影 微泡 生理盐水 葡萄糖 卵圆孔未闭 

分 类 号：R981[医药卫生—药品]