经胸多普勒超声心动图冠状动脉显像技术对单纯左前降支狭窄患者血流动力学的研究  

Assessment of hemodynamics in patients with only left anterior descending branch stenosis by transthorac doppler echocardiography coronary flow imaging

作　　者：张鹏[1] 高洁 陈连香[1] 王威 ZHANG Peng;GAO Jie;CHEN Lian-xiang;WANG Wei(Department of Imaging Diagnosis,the Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010010,China;Medical Imaging Department,Inner Mongolia People's Hospital,Hohhot 010020,China)

机构地区：[1]内蒙古医科大学附属医院影像诊断科,内蒙古自治区呼和浩特市010050 [2]内蒙古自治区人民医院影像医学科

出　　处：《中国心血管病研究》2020年第3期232-235,共4页Chinese Journal of Cardiovascular Research

基　　金：内蒙古自治区自然科学基金项目[2017MS(LH)0835]。

摘　　要：目的 以冠状动脉造影(CAG)为金标准,应用经胸多普勒超声心动图冠状动脉显像技术(TTDE-CFI)探讨单纯左前降支(LAD)不同狭窄程度的血流参数改变.方法 选取我院2016年10月至2018年10月入院患者75例,并于CAG前2 h行TTDE-CFI检查,记录LAD中远段血流信号频谱,测量收缩期峰值流速(PSV)、舒张期峰值流速(PDV)、舒张期平均流速(MDV)、舒张期加速度(DAR)、舒张期减速度(DDR)、舒张期速度时间积分(DVTI)和舒张期与收缩期峰值流速比值(DSVR).根据CAG结果,取CAG正常者27例(对照组),单纯LAD狭窄率在50%~75%患者25例(A组)、单纯LAD狭窄大于75%患者23例(B组),回顾性分析不同程度单纯LAD狭窄患者冠状动脉支架置入术前血流动力学参数改变情况.结果 对照组LAD远端多普勒超声心动图显示为红色前向血流,LAD狭窄患者显示红色或五彩湍流血流.三组之间PDV、MDV、DAR、DDR、DVTI、DSVR比较均有统计学意义[(0.28±0.03)m/s比(0.43±0.17)m/s比(0.67±0.15)m/s、(0.24±0.08)m/s比(0.43±0.17)m/s比(0.61±0.13)m/s、(3.41±1.67)m/s2比(5.52±1.91)m/s2比(8.74±2.23)m/s2、(0.36±0.14)m/s2比(0.52±0.21)m/s2比(0.91±0.36)m/s2、(0.08±0.04)m比(0.17±0.03)m比(0.26±0.12)m、1.62±0.41比2.72±0.56比3.97±0.75,P<0.05],而三组之间PSV比较均无统计学意义[(0.14±0.03)m/s比(0.15±0.02)m/s比(0.15±0.03)m/s,P>0.05].结论 TTDE-CFI技术是诊断和评价冠状动脉狭窄程度的一种无创、简单、重复性较高的新方法.Objective Transthoracic doppler echocardiographic coronary angiography(TTDE-CFI)was used to investigate the changes in blood flow parameters of the left anterior descending artery(LAD)with simple stenosis and different stenosis degrees.Coronary angiography(CAG)was the gold standard.Methods We selected 75 to be admitted to our hospital between October 2016 and October 2018.All the patients did社de-cfi before the CAG,the frequency spectrum of blood flow signal in the middle and far part of the LAD was recorded.We measured systolic peak velocity(PSV),diastolic peak velocity(PDV),mean diastolic velocity(MDV),diastolic acceleration(DAR),diastolic deceleration(DDR),diastolic velocity time integral(DVTI)and diastolic to systolic peak velocity ratio(DSVR).According to the CAG results,we selected 27 patients with normal coronary angiography(control group),25 patients with LAD stenosis rate between 50%-75%(group A)and 23 patients with LAD stenosis rate more than 75%(group B).We retrospectively analyzed,before they had coronary stenting,patients with LAD stenosis alone,with varying degrees of stenosis,had changes in their sonodoppler hemodynamic parameters.Results Un the control group.the patients with LAD stenosis showed red or multicolored turbulent blood flow.PDV,MDV,DAR,DDR,DVT1,DSVR had statistical significance among the three groups[(0.28±0.03)m/s vs.(0.43±0.17)m/s vs.(0.67±0.15)m/s,(0.24±0.08)m/s vs.(0.43±0.17)m/s vs.(0.61±0.13)m/s,(3.41±1.67)m/s2 vs.(5.52±1.91)m/s2 vs.(8.74±2.23)m/s2,(0.36±0.14)m/s2 vs.(0.52±0.21)m/s2 vs.(0.91±0.36)m/s2,(0.08±0.04)m vs.(0.17±0.03)m vs.(0.26±0.12)m.1.62±0.41 vs.2.72±0.56 vs.3.97±0.75,P<0.05 j,while PSV had no statistical significance among the three groupsL(0.14±0.03)m/s vs.(0.15±0.02)m/s vs.(0.15±0.03)m/s,P>0.05].Conclusion TTDE-CFI technology is a new method for diagnosing and evaluating the degree of coronary artery stenosis,and it is non-invasive,simple and repeatable.

关 键 词：经胸多普勒超声心动图 左前降支 冠状动脉疾病 

分 类 号：R540.45[医药卫生—心血管疾病]