MCE评估不同时机植入支架对急性STEMI患者微循环灌注的影响  

Evaluation of Microcirculation Perfusion in Patients with Acute ST Segment Elevation Myocardial Infarction At Different Stenting Timing by Myocardial Contrast Echocardiography

作　　者：梁萌萌 吕伟扬 田家玮[1] 冷晓萍[1] Liang Mengmeng;Lü Weiyang;Tian Jiawei;Leng Xiaoping(Department of Ultrasonography,the Second Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang 150086.China)

机构地区：[1]哈尔滨医科大学附属第二医院超声医学科,哈尔滨市150086

出　　处：《中国超声医学杂志》2021年第5期527-530,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金面上项目(No.81971626)。

摘　　要：目的探讨心肌声学造影(MCE)评估急性ST段抬高型心肌梗死(STEMI)患者接受不同时机支架植入后微循环灌注变化的价值。方法选取急性STEMI患者111例,随机分为即刻支架组(IS)与延迟支架组(DS)。所有患者分别于支架植入术后1周及1个月进行常规超声心动图及MCE检查,测量左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、射血分数(EF)、室壁运动积分指数(WMSI)、室壁灌注评分指数(PSI)、心肌血容量(A)、血流速度(β)和血流量(A×β)。结果支架植入前,两组患者一般情况比较无显著差异(P>0.05)。支架植入后1个月,DS组与IS组相比LVEDV、LVESV及WMSI减低,A、β及A×β增加,差异均有统计学意义(P<0.05)。DS组术后1个月与术后1周组内比较LVEDV、LVESV、WMSI及PSI减低,A、β及A×β增加,差异均有统计学意义(P<0.05)。结论延迟植入支架有利于急性STEMI患者微循环灌注及左室收缩功能改善,MCE可用于支架植入术后疗效观察。Objective To investigate the value of myocardial contrast echocardiography(MCE)in the evaluation of myocardial perfusion in patients with acute ST segment elevation myocardial infarction(STEMI)after stent implantation at different timing.Methods 111 patients with acute STEMI were randomly divided into immediate stenting(IS)and delayed stenting(DS).Echocardiography and MCE were performed at 1 week and 1 month after stent implantation respectively.Meanwhile,the left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),ejection fraction(EF),wall motion score index(WMSI),perfusion score index(PSI)and the MCE quantitative parameters of A,βand A×βwere quantified.Results Before stent implantation,there was no significant difference in general condition between the two groups(P>0.05).At 1 month after stent implantation,LVEDV,LVESV and WMSI in DS were significantly lower than IS;A,βand A×βin DS were significantly higher than IS(P<0.05).In DS group,LVEDV,LVESV,WMSI and PSI at 1 month after stent implantation were lower;A,β,and A×βwere significantly higher than those at 1 week(P<0.05).Conclusions Delayed stent implantation can improve myocardial perfusion and left ventricular systolic function in patients with acute STEMI,and MCE can be used to evaluate the efficacy of stent implantation.

关 键 词：急性ST段抬高型心肌梗死 支架植入 心肌声学造影 微循环灌注 

分 类 号：R542.22[医药卫生—心血管疾病]