冠脉内多普勒血流速度描记评价介入治疗效果

目的 应用冠状动脉内多普勒血流速度描记技术，评价经皮冠状动脉球囊扩张术（ＰＴＣＡ）及支架植入术对冠脉血流储备的影响。方法 对２１支（１８例）有狭窄病变的冠状动脉进行ＰＴＣＡ术，其中１６支冠脉ＰＴＣＡ术后植入支架。在ＰＴ－ＣＡ前后和支架植入术后，采用Ｃａｒｄｉｏｍｅｔｒｉｃ ＦｌｏＭａｐⅡ血管腔内多普勒血流速度描记仪和多普勒导丝，测量狭窄近端和远端的平均峰值流速（ＡＰＶ）、舒张期与收缩期流速比（ＤＳ

Evaluation of the therapeutic effect of coronary interventions with intracoronary Doppler flow velocity recording

Objective To evaluate the effect of percutaneous transluminal coronary balloon angioplasty (PTCA) andstent implantation on coronary flow reserve by using intracoronary Doppler flow velocity recording. Methods PTCA was per-formed on 21 coronary arteries of 18 patients with coronary stenosis lesion and 16 of them underwent adjunctive stent implan-tation following PTCA. Coronary flow velocity was recorded by using Cardiometric FloMap Ⅱ by introducing the Dopplerflowire into the target arteries. The average peak veloity (APV) and coronary flow reserve (CFR) were measured before anafter PTCA and after stent implantation. Ten coronary arteries had data both after PTCA and after stent implantation. ResultsThe baseline diameter stenosis was (81.2 ± 14.4)％. The difference between proximal APV at baseline and APV after PTCAor (and) stenting had no significant (P＞0. 05). The poststenotic APV was increased from initial value after PTCA (P＜0. 05) and after stenting (P＜0. 01). There was no significant difference in the proximal/distal velocity ratio (P/DVR) beforeand after PTCA(P＞0. 05) ,but P/DVR was obviously decreased after stenting (P＜0. 05). The hyperemic APV was signifi-cantly increased after PTCA and stenting (both P＜0. 01). The proximal stenosis CFR was improved after PTCA (P＜0. 05)and after stenting (P＜0. 01). There was no significant difference in proximal stenosis APV,P/DVR and CFR between afterPTCA and after stenting (P＞0. 05). Conclusion Intracoronary Doppler flow velocity recording could be used to assess thetherapeutic effect during PTCA and stenting.