摘要
目的探讨实时心肌超声造影(RTMCE)在评价冠状动脉支架置入术疗效中的应用价值。方法观察20例拟行支架置入术的冠心病患者和7例正常人双嘧达莫负荷前后RTMCE闪烁显像时心肌血流再灌注情况,对心肌血流再灌注的时间-密度曲线形态及相应的平台期心肌显影强度(A)、再灌注曲线上升平均斜率(β)和A.β值进行分析,并评估储备值的变化。结果治疗前,静息状态下灌注异常的病变节段A、β及A.β明显低于正常心肌;负荷后,A、β及A.β的储备值较正常组显著降低。静息状态下灌注正常的病变节段A、β及A.β与正常心肌差异无统计学意义,负荷后A、β及A.β的储备值明显低于正常心肌。治疗后1个月,缺血心肌灌注明显改善,原基础状态和负荷后再灌注时间-密度曲线降低的指标较术前逐渐恢复。结论冠状动脉支架置入术可有效挽救存活心肌,RTMCE具备定量评价心肌微循环灌注的能力。
Objective To investigate the application of real-time myocardial contrast echocardiography （RTMCE） to estimate myocardial regional microcirculation reperfusion pre- and post-intracoronary stent implantation. Methods Twenty cases with coronary artery disease（CAD） screened by coronary angiography to perform intracoronary stent implantation were employed in experimental group and 7 healthy cases in control group, RTMCE was performed pre- and post-operation. During the contrast agents infusion and incremental triggering,myocardial reperfusion was observed pre- and post-dipyridamole injection. The time-amplitude curves, the maximal amplitude score（A）,the mean ascending slope of the curve （13） and A ·β, the changes of the reserve of A,β and A ·β were analyzed. Results Before treatment,for the ischemia segments with abnormal perfusion at baseline,A, β and A ·β significantly decreased pre-stress,the reserve of A,β and A ·β lowered post-stress. For the ischemia segments with normal perfusion at baseline,the value of A,β and A ·β didn＇t change compared with normal myocardium pre-stress,while the reserve of A,β and A ·β significantly reduced post stress. One month post-operation,reperfusion of ischemia myocardium obviously improved, data attained by using time-amplitude curves gradually recovered than that of preoperation. Conclusions Intracoronary stent implantation can effectively save the viable myocardium. RTMCE is precise in estimating the perfusion of myocardial microcirculation.
出处
《中华超声影像学杂志》
CSCD
2006年第2期88-91,共4页
Chinese Journal of Ultrasonography
