PCI术后不同心肌灌注表现患者心肌声学造影特征及预后的关联性分析  

Analysis of the correlation between myocardial contrast echocardiography characteristics and prognosis in patients with different myocardial perfusion after PCI

作　　者：温玉双 刘姣 毕希乐[1] WEN Yu-shuang;LIU Jiao;BI Xi-le(CCU,Qinhuangdao First Hospital,Qinhuangdao Hebei 066000,China;Department of Cardiovascular Surgery,Qinhuangdao First Hospital,Qinhuangdao Hebei 066000,China)

机构地区：[1]秦皇岛市第一医院CCU,河北秦皇岛066000 [2]秦皇岛市第一医院心血管外科,河北秦皇岛066000

出　　处：《临床和实验医学杂志》2025年第4期363-367,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省医学科学研究课题计划项目(编号:20221623)。

摘　　要：目的探究经皮冠状动脉介入术(PCI)术后不同心肌灌注表现患者心肌声学造影特征及与预后的关联性。方法采用回顾性研究,共纳入2022年10月至2024年5月秦皇岛市第一医院收治的160例PCI治疗患者,均接受心肌声学造影检查,评价心肌灌注表现。根据灌注情况分为灌注正常组(n=116)和灌注异常组(n=44)。记录两组患者的临床指标、实验室指标、心功能指标、相关心肌声学造影参数(毛细血管横截面积之和A、血流速度β、A×β、血流灌注指数、TIMI血流评价、校正的TIMI帧数评分、室壁运动评分指数、心肌灌注评分指数、微循环血流量)情况,记录患者发生不良心血管事件的情况,分析不良心血管事件发生与其心肌声学造影参数的关联。采用受试者操作特征(ROC)曲线探究各指标对患者预后不良的预测价值。结果灌注正常组患者和灌注异常组患者的临床指标、实验室指标及心功能指标比较,差异均无统计学意义(P>0.05);灌注异常组患者的毛细血管横截面积之和A、血流速度β、A×β、微循环血流量分别为(5.44±1.46)dB、(0.56±0.18)dB/s、(2.66±1.44)dB^(2)/s、(25.48±5.11)IU/s,均低于灌注正常组[(22.16±2.12)dB、(1.22±0.45)dB/s、(26.44±8.77)dB^(2)/s、(52.66±8.98)IU/s],灌注异常组血流灌注指数、TIMI血流评价≤Ⅱ级占比分别为5.11±1.12、43.18%,均高于灌注正常组(2.36±0.78、19.83%),差异均有统计学意义(P<0.05)。33例出现不良心血管事件的患者纳入预后不良组,127例未发生不良心血管事件的患者纳入预后良好组。预后不良组毛细血管横截面积之和A、血流速度β、A×β、校正的TIMI帧数评分<40占比、微循环血流量分别为(4.88±1.21)dB、(0.49±0.22)dB/s、(2.45±1.51)dB^(2)/s、43.18%、(24.98±5.23)IU/s,均低于预后良好组[(25.45±4.46)dB、(1.31±0.31)dB/s、(28.44±6.45)dB^(2)/s、85.34%、(53.54±7.78)IU/s],预后不良组血流灌注指数、室壁运动评�Objective To explore the correlation between myocardial contrast echocardiography(MCE)characteristics and prognosis in patients with different myocardial perfusion after percutaneous coronary intervention(PCI).Methods A retrospective study was conducted.A total of 160 patients who received PCI treatment in the Qinhuangdao First Hospital from October 2022 to May 2024 were included.All patients underwent myocardial contrast echocardiography to evaluate the manifestations of myocardial perfusion.According to the perfusion status,they were divided into the normal perfusion group(n=116)and the abnormal perfusion group(n=44).The clinical indexes,laboratory indexes,cardiac function indexes and related myocardial contrast echocardiography parameters(the sum of capillary cross-sectional areas A,blood flow velocityβ,A×β,blood perfusion index,TIMI blood flow assessment,corrected TIMI frame count score,wall motion score index,myocardial perfusion score index,microcirculation blood flow)of the two groups were recorded.The occurrence of adverse cardiovascular events in patients was also recorded.The correlation between adverse cardiovascular events and myocardial contrast parameters was analyzed.The predictive value of the indicators for poor prognosis of patients was explored using the receiver operating characteristic(ROC)curve.Results There were no statistically significant differences in clinical indexes,laboratory indexes and cardiac function indexes between normal perfusion group and abnormal perfusion group(P>0.05);the sum of capillary cross-sectional area A,blood flow velocityβ,A×β,and microcirculation blood flow in the abnormal perfusion group were(5.44±1.46)dB,(0.56±0.18)dB/s,(2.66±1.44)dB^(2)/s,and(25.48±5.11)IU/s,respectively,which were lower than those in the normal perfusion group[(22.16±2.12)dB,(1.22±0.45)dB/s,(26.44±8.77)dB^(2)/s,(52.66±8.98)IU/s],the proportion of blood perfusion index and TIMI blood flow evaluation≤gradeⅡwere 5.11±1.12 and 43.18%,respectively,which were higher than those in

关 键 词：经皮冠状动脉介入术 心肌灌注 心肌声学造影特征 预后 

分 类 号：R541.4[医药卫生—心血管疾病]