心肌灌注变化对冠状动脉旁路移植术预后的预测价值  

Predictive value of myocardial perfusion in the prognosis after coronary artery bypass grafting

作　　者：王文君 潘晓芳[2] 高峰[1] 张博[2] 孙飞一[2] 庄熙晶[1] 何学志[1] WANG Wenjun;PAN Xiaofang;GAO Feng;ZHANG Bo;SUN Feiyi;ZHUANG Xijing;HE Xuezhi(Department of Cardiovascular Surgery,Dalian Municipal Central Hospital,Dalian,116033,Liaoning,P.R.China;Department of Cardiovascular Ultrasound Imaging,Dalian Municipal Central Hospital,Dalian,116033,Liaoning,P.R.China)

机构地区：[1]大连市中心医院心脏大血管外科,辽宁大连116033 [2]大连市中心医院超声影像科,辽宁大连116033

出　　处：《中国胸心血管外科临床杂志》2020年第12期1423-1428,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的评估冠状动脉旁路移植术(CABG)前后心肌灌注变化对术后主要心血管不良事件(MACE)的预测价值。方法选取2017年1~11月由同一术者完成的CABG患者70例,其中男45例、女25例,平均年龄(64.83±9.09)岁。以随访期间是否发生MACE为依据将入组患者进行分组,术后1年未出现MACE 60例(A组),出现MACE 10例(B组)。比较两组患者的临床资料。结果A组术前及术后各冠状动脉支配区域心肌灌注超声(MCE)总分值差异有统计学意义(P<0.05),术前及术后1年心脏超声结果示左心室大小及左心室射血分数差异有统计学意义(P<0.001),左心房大小差异无统计学意义(P=0.075)。B组术前及术后MCE各项分值差异均无统计学意义(P>0.05),术前及术后1年心脏超声差异也无统计学意义(P>0.05)。结论CABG患者术后心肌灌注改善情况可能与患者术后MACE发生有关。CABG术前及术后完善心肌灌注评估,对于患者预后评估有重要意义。Objective To evaluate the value of myocardial perfusion change before and after coronary artery bypass grafting(CABG)in predicting postoperative major adverse cardiovascular events(MACE).Methods A total of 70 CABG patients who received CABG completed by the same operator from January to November 2017 were selected,including 45 males and 25 females with an average age of 64.83±9.09 years.The patients were divided into two groups according to whether the patients had MACE after 1 year of the surgery,including a non-MACE group(group A,n=60)and a MACE group(group B,n=10).The clinical data of patients were compared.Results There were statistical difference in the myocardial contrast echocardiography(MCE)score in the group A before and after surgery(P<0.05),and there were statistically significant differences in the left ventricular size and left ventricular ejection fraction(LVEF)value before and 1 year after surgery(P<0.001),but no statistically significant difference in the size of left atrium(P=0.075).There was no significant difference in the preoperative and postoperative MCE score,and preoperative and postoperative 1-year cardiac ultrasound score in the group B(P>0.05).Conclusion The change of myocardial perfusion after CABG surgery is associated with postoperative MACE.The evaluation of myocardial perfusion before and after CABG surgery is of great significance for the prognosis evaluation of patients.

关 键 词：心肌灌注 冠状动脉旁路移植术 主要心血管不良事件 预后 

分 类 号：R654.2[医药卫生—外科学]