多巴酚丁胺负荷超声心动图评价慢性闭塞病变介入治疗效果  

Effect of interventional therapy on chronic total occlusion by doubutamine stress echocardiography evaluation

作　　者：王晶[1] 刘博罕 穆洋[1] 徐勇[1] 智光[1] 陈韵岱[1] WANG Jing, LIU Bo-han, MU Yang, XU Yong, ZHI Guang, CHEN Yun-dai.(Department of Cardiology, Chinese PLA General Hospital, Beijing 100853, Chin)

机构地区：[1]中国人民解放军总医院心血管内科,北京100853

出　　处：《中国介入心脏病学杂志》2018年第2期68-73,共6页Chinese Journal of Interventional Cardiology

基　　金：解放军总医院科技创新苗圃项目(13KMZ01)

摘　　要：目的应用负荷超声心动图评价冠状动脉慢性完全闭塞病变介入治疗效果。方法46例慢性完全闭塞患者根据介入治疗结果分为开通组和未通组,并在介入治疗术前和随访6个月时分别完成低剂量多巴酚丁胺负荷试验,应用半定量方法测定静息和负荷状态下室壁运动积分指数(WMSI)。同时应用三维超声心动图测定左心室容积和左心室射血分数。结果两组患者基线状态一般临床资料和各项超声心动图资料差异均无统计学意义。开通组术后在射血分数[(60.00±3.22)%比(62.65±3.58)%,P=0.017]、负荷状态下WMSI[(1.42±0.37)比(1.32±0.36),P<0.001]与术前结果相比,均有显著改善;射血分数[(62.65±3.58)%比(57.7±5.61)%,P=0.001)]和负荷状态下WMSI[(1.32±0.36)比(1.62±0.47),P<0.001]与未通组相比,均有显著改善。结论低剂量多巴酚丁胺负荷超声心动图可有效评估慢性完全闭塞病变介入治疗效果。成功开通慢性完全闭塞病变血管对于左心室容积和左心室整体收缩功能以及负荷状态下室壁运动均有一定的改善作用。Objective To evaluate the effect of percutaneous coronary intervention（PCI） on chronic total occlusion（OCT） by doubutamine stress echocardiography. Methods Forth-six CTO patients were categorized into the reopening group and failed-reopening group based on the results of PCI. All patients had undergoing low dose doubutamine stress echocardiography before PCI and at 6-month followup, measuring rest and stress wall motion score index（WMSI） with semi-quantitative method. Cardiac volumes and ejection fraction were measured with 3 D f ull volume echocardiographic. Results The two groups showed no differences in general clinical data and all baseline echocardiography data before PCI. During follow-up, the reopening group was observed to have improvement in ejection fraction[（60.00±3.22）%vs.（62.65±3.58）%, P=0.017）], and WMSI in stress status[（1.42±0.37）vs.（1.32±0.36）,P〈0.001],compared with pre-PCI results. The reopening group showed improvement in ejection fraction[（62.65±3.58）%vs.（57.7±5.61）%, P=0.001）]and WMSI in stress status[（1.32±0.36） vs.（1.62±0.47）, P〈0.001）], when compared with the failed-reopening group. Conclusions Low dose doubutamine stress echocardiography can be nsed for evaluation of the effect of revascularization of CTO. The cardiac volumes and contractile f unction representing by wall motion in stress status were improved after recanalization of CTO.

关 键 词：慢性完全闭塞病变 经皮冠状动脉介入治疗 多巴酚丁胺负荷超声心动图 室壁运动积分 三维超声心动图 

分 类 号：R541.4[医药卫生—心血管疾病]