心肌超声造影评估心梗患者心肌微循环损伤程度  

Myocardial microcirculation injury evaluated by myocardial contrast echocardiography in patients with myocardial infarction

作　　者：郭景 邓又斌[1] 刘娅妮 杨好意 周玮[1] 张隽[1] GUO Jing;DENG You-bin;LIU Yani(Department of Medical Ultrasound,Tongji Hospital of Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院超声影像科,武汉430030

出　　处：《放射学实践》2018年第10期1093-1096,共4页Radiologic Practice

基　　金：国家自然基金项目(81571695)

摘　　要：目的:应用心肌超声造影(MCE)定性、定量指标评估心肌梗死患者微循环损伤程度及评估其与冠脉造影Gensini评分的相关性。方法:心内科疑诊心肌梗死患者35例,行心肌超声造影检查记录射血分数(EF),评估室壁运动评分指数(WMSI),MCE定性评估心肌灌注评分(PS),定量评估室壁节段A值,β值及A×β值。据患者冠脉造影结果评估Gensini评分。评估EF、WMSI、PS与Gensini评分之间的相关性。结果:MCE定性分析将心肌节段分为正常灌注节段组、灌注不均匀节段组、灌注缺损节段组3组,MCE定量指标A、β、A×β值在3组间逐渐减小,A(dB)值分别为8.61±0.86vs 7.30±0.73vs 5.98±0.82,β(s-1)值分别为0.69±0.08vs 0.44±0.07vs 0.26±0.05,A×β(dB/s)值分别为5.94±0.92vs 3.25±0.69vs 1.54±0.33,差异具有统计学意义。PS与EF、WMSI之间的相关性高于Gensini评分与EF、WMSI的相关性(与EF的相关性:-0.751vs-0.536,与WMSI的相关性:0.859vs 0.580)。结论:MCE定性指标与左室功能指标有较好的相关性,定量指标与定性评估有较好的一致性,MCE通过定性和定量分析对评估心肌梗死患者微循环损伤程度有价值。Objective:To evaluate the microcirculation injury with qualitative and quantitative myocardial contrast echocardiography(MCE)and assess the relationship with gensini score obtained by coronary angiography(CA)in patients with myocardial infarction.Methods:35 cases of suspected myocardial infarction in Department of cardiology of our hospital were examined by myocardial contrast echocardiogarphy.LV function with ejection fraction(EF)and wall motion score index(WMSI)were estimated.Qualitative perfusion score(PS)and quantitation value of A,β,and A×βof myocardial segments were obtained.Gensini score was calculated from coronary angiography.Correlations among between EF,WMSI,PS and Gensini score were analyzed.Results:Myocardial segments was divided into normal perfusion,nonuniform perfusion,perfusion defect respectively by qualitative analysis in MCE.Quantitative analysis between the three groups were significantly different in A,β,and A×β.A(dB)values were 8.61±0.86 vs 7.30±0.73 vs 5.98±0.82,β(s-1)values were 0.69±0.08 vs 0.44±0.07 vs 0.26±0.05,A×β(dB/s)values were 5.94±0.92 vs 3.25±0.69 vs 1.54±0.33 respectively in three groups,the difference was statistically significant.The correlation among PS and EF and WMSI is higher than that of gensini score and EF and WMSI(correlation with EF:-0.751 vs-0.536,correlation with WMSI:0.859 vs 0.580).Conclutions:There was a good correlation between qualitative indexes of MCE and left ventricular function,and there was a good consistency between quantitative indexes and qualitative evaluation.Myocardial contrast echocardiography is a promising method for evaluating microvascular injury degree in patients with myocardial infarction.

关 键 词：心肌 超声检查 心肌梗死 微循环 

分 类 号：R322.11[医药卫生—人体解剖和组织胚胎学] R445.1[医药卫生—基础医学]