心肌声学造影评估冠脉慢性完全闭塞病变介入治疗效果及预后的价值  

Value of Myocardial Contrast Echocardiography to Assess the Effectiveness and Prognosis of Interventional Treatment for Chronic Total Occlusion Lesions in Coronary Arteries

作　　者：黄艳焦 廖倩雯 李业钊[1] HUANG Yanjiao;LIAO Qianwen;LI Yezhao(Department of Ultrasound Medicine,Guangxi Zhuang Autonomous Region National Hospital,Nanning,Guangxi Zhuang Autonomous Region,530001 China)

机构地区：[1]广西壮族自治区民族医院超声医学科,广西南宁530001

出　　处：《世界复合医学》2023年第3期26-29,共4页World Journal of Complex Medicine

基　　金：广西壮族自治区健康委员会自筹经费科研课题(Z20210157)。

摘　　要：目的探讨心肌声学造影(myocardial contrast echocardiography,MCE)评估冠脉慢性完全闭塞病变(chronic total occlusion,CTO)介入治疗效果及预后的价值。方法选取2021年4月—2022年3月广西壮族自治区民族医院超声医学科收治的行经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)的冠状动脉慢性完全闭塞病变患者60例为研究对象。所有患者于PCI术前1 d及术后3个月行MCE检查。根据“金标准”,分析目测半定量法、图像定量法对存活心肌的诊断效能。结果与金标准相比,心肌声学造影目测半定量法对存活心肌的评估敏感度73.39%,假阴性率26.61%,假阳性率25.96%,特异度74.04%,准确性73.66%,阳性预测值79.80%,阴性预测值66.57%;心肌声学造影图像定量法对存活心肌的评估为敏感度88.07%、假阴性率11.93%、假阳性率28.53%、特异度71.47%、准确性81.15%、阳性预测值81.18%、阴性预测值81.10%。结论心肌声学造影图像定量法用于评估冠状动脉慢性完全闭塞病变介入治疗,可以更客观、更准确地评估存活心肌数目,判断冠状动脉微循环的血流灌注,能为临床医师提供一定参考。Objective To explore the value of myocardial contrast echocardiography(MCE)in evaluating the efficacy and prognosis of chronic total occlusion(CTO).Methods A total of 60 patients with chronic complete occlusive coronary lesions of the coronary arteries who underwent percutaneous coronary intervention(PCI)admitted to the Department of Ultrasound Medicine of Guangxi Zhuang Autonomous Region Hospital for Nationalities from April 2021 to March 2022 were enrolled.All patients underwent MCE examination 1 day before PCI and 3 months after surgery.According to the"gold standard",the diagnostic efficacy of visual semi-quantitative method and image quantitative method on surviving myocardium was analyzed.Results Compared with the gold standard,the semi-quantitative evaluation of surviving myocardium by visual myocardial acoustic imaging was 73.39% sensitive,26.61% false-negative,25.96% false-positive,74.04% specific,73.66%accurate,79.80% positive and 66.57% negative.The quantitative evaluation of surviving myocardium by myocardial acoustic contrast image was 88.07%sensitivity,false-negative rate of 11.93%,false-positive rate of 28.53%,specificity of 71.47%,accuracy of 81.15%,positive predictive value of 81.18%,and negative predictive value of 81.10%.Conclusion Myocardial acoustic angiography image quantitative method is used to evaluate the interventional treatment of chronic complete occlusive lesions of coronary arteries,which can more objectively and accurately assess the number of surviving myocardiums and judge the blood perfusion of coronary microcirculation,which can provide some reference for clinicians.

关 键 词：心肌声学造影 冠状动脉慢性完全闭塞病变 介入治疗 预后 

分 类 号：R730.41[医药卫生—肿瘤]