心肌声学造影在冠心病中的应用  

Myocardial contrast echocardiography in coronary artery disease

作　　者：刘昕[1] 徐伟仙[1] Liu Xin;Xu Weixian(Department of Cardiology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院心血管内科,北京100191

出　　处：《中国医学前沿杂志（电子版）》2022年第4期54-58,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：国家“重大新药创制”科技重大专项资助项目(2017ZX09304012-014)。

摘　　要：评估心肌灌注的情况对于冠心病的诊断、治疗决策和预后判断至关重要。心肌声学造影是利用超声增强剂对冠状动脉(简称冠脉)及其微血管血流显像的技术。心肌声学造影负荷超声心动图是心肌声学造影技术与负荷超声心动图的结合,通过负荷状态下微血管血容量、心肌血流量和冠脉血流储备等参数可对心肌灌注情况进行定量评估。这些心肌声学造影技术对冠心病的诊断有良好的敏感性和特异性,对冠心病的预后判断也有良好的预后价值。心肌声学造影指导下的超声溶栓利用高机械参数脉冲下剪切依赖的血管扩张途径和微泡空化破裂的机械性侵蚀血栓作用来实现心外膜冠脉再通并改善心肌微循环,能有效缩小心肌梗死范围,是未来极具潜力的冠心病治疗方法。Assessment of myocardial perfusion is essential for the diagnosis,treatment decisions and prognosis of coronary heart disease.Myocardial contrast echocardiography uses ultrasonic enhancing agents to visualize blood flow in the coronary arteries and their microvasculature.Myocardial contrast stress echocardiography is a combination of myocardial contrast echocardiography and stress echocardiography,which allows quantitative assessment of myocardial perfusion through parameters such as microvascular blood volume,myocardial blood flow and coronary flow reserve under stress.Myocardial contrast echocardiography has good sensitivity and specificity for the diagnosis of coronary artery disease and good prognostic value for determining its prognosis.Sonothrombolysis guided by myocardial contrast echocardiography is a promising future treatment for coronary artery disease.It utilizes the shear-dependent vasodilator pathway and the mechanical erosive thrombotic effect of microbubble cavitation rupture in high mechanical index pulse to achieve epicardial coronary revascularization and improve myocardial microcirculation,which can effectively reduce the size of myocardial infarction.

关 键 词：冠心病 心肌声学造影 心肌灌注显像 超声溶栓 超声增强剂 

分 类 号：R541.4[医药卫生—心血管疾病]