心肌超声造影对冠心病经皮冠脉支架术的效果评价  

Effect evaluation of myocardial contrast echocardiography on percutaneous coronary stenting of coronary heart disease

作　　者：刘学彬 覃夏川 刘涛 邓建平 陈华平 何兴华 苏军 杨姣 LIU Xuebin;QIN Xiachuan;LIU Tao;DENG Jianping;CHEN Huapin;HE Xinghua;SU Jun;YANG Jiao(Department of Ultrasound, Nanchong Central Hospital, The Second Clinical Medical College of North Sichuan Medical College, Nanchong 637000, Sichuan, China;Department of Cardiology, Nanchong Central Hospital, The Second Clinical Medical College of North Sichuan Medical College, Nanchong 637000, Sichuan, China;CT Room, Nanchong Central Hospital, The Second Clinical Medical College of North Sichuan Medical College, Nanchong 637000, Sichuan, China)

机构地区：[1]南充市中心医院·川北医学院第二临床医学院超声科,四川南充637000 [2]南充市中心医院·川北医学院第二临床医学院心内科,四川南充637000 [3]南充市中心医院·川北医学院第二临床医学院CT室,四川南充637000

出　　处：《西部医学》2021年第2期292-296,共5页Medical Journal of West China

基　　金：南充市财政局科研项目(KY-16YFZJ0033)。

摘　　要：目的评估心肌超声造影(MCE)对冠心病经皮冠脉支架术的应用价值。方法对90例冠心病经皮冠脉支架术患者前后的二维超声节段运动、超声造影节段运动、室壁血流灌注结果与经导管冠脉造影进行比较。术后6个月随访23例患者,比较患者术后3~7天及术后6个月的超声心肌造影检查与冠脉造影结果。结果术前超声造影提示752个节段运动异常,与二维超声检查结果(514个节段运动异常)比较差异有统计学意义(P<0.05)。超声血流灌注提示677个节段灌注异常,与二维超声结果比较差异有统计学意义(P<0.05)。超声造影与冠脉造影吻合率80.9%(752/930),室壁运动及血流灌注异常与冠脉造影比较差异无统计学意义(P>0.05)。术后6个月超声造影提示节段显示及血流灌注情况与二维超声结果差异均存在统计学意义(P<0.05),超声造影与冠脉造影比较无明显差异(P>0.05)。结论术前心肌超声造影诊断心肌梗塞的准确率明显高于二维超声,与经导管冠脉造影结果接近,在冠脉介入术后近期及6个月内MCE能敏感地发现异常心肌,较二维超声具有更高的敏感性与特异性;MCE既可以作为术前诊断心肌梗塞的常规手段,也可以作为冠心病经皮冠脉支架术后患者效果的评价与随访手段。Objective To evaluate the value of myocardial contrast echocardiography(MCE)in percutaneous coronary stenting of coronary heart disease.Methods The results of two-dimensional ultrasound segmental motion,contrast-enhanced ultrasound segmental motion and ventricular wall blood flow perfusion before and after percutaneous coronary stenting in 90 patients with coronary heart disease were compared with those of transcatheter coronary angiography.Twenty three patients were followed up 6 months after operation.The results of myocardial contrast echocardiography and coronary angiography were compared 3-7 days and 6 months after operation.Results The results of contrast-enhanced ultrasound before operation showed 752 segments with abnormal motion,which was significantly different from that of two-dimensional ultrasound(514 segments with abnormal motion)(P<0.05).There were significant differences between the results of ultrasound and two-dimensional ultrasound(P<0.05).The coincidence rate between CEUS and CAG was 80.9%(752/930).There was no significant difference in wall motion and blood perfusion between CEUS and CAG(P>0.05).At 6 months after operation,there were statistically significant differences in segmental display and blood perfusion between CEUS and two-dimensional ultrasound(P<0.05),but there was no significant difference between CEUS and coronary angiography(P>0.05).Conclusion The accuracy of preoperative myocardial contrast-enhanced echocardiography in the diagnosis of myocardial infarction is significantly higher than that of two-dimensional echocardiography,which is close to the results of transcatheter coronary angiography.MCE can sensitively detect abnormal myocardium in the short term and within 6 months after coronary intervention,which has higher sensitivity and specificity than two-dimensional echocardiography.MCE can be used as a routine means of preoperative diagnosis of myocardial infarction,and can also be used as a percutaneous coronary artery branch of coronary heart disease Objective to evaluate

关 键 词：冠心病 超声造影 经皮冠脉支架术 室壁节段运动 心肌灌注 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.4[医药卫生—诊断学]