心肌超声造影对冠状动脉介入治疗术后心肌血流再灌注的临床研究

目的 探讨心肌超声造影(MEC)对冠状动脉介入治疗(PCI)术后心肌血流再灌注定量分析的价值.方法 对15例冠心病患者分别于PCI术前及PCI术后在对比脉冲序列成像条件下行心肌超声造影检查.采用自动追踪增强定量分析软件进行分析.得出造影剂强度(A)、斜率(β)、A×β、造影剂到达时间(AT)及达峰时间(TTP).结果 所有患者均获得清晰的左心室显影.正常灌注区均获得较满意的心肌显影,而缺血区心肌显影不良.异常灌注区域AT、TTP均较正常灌注区域延长,而A×β则显著减小(P＜0.05);单支冠脉狭窄＞70%息者PCI术后的A、β及A×β较术前明显改善(P＜0.05),而冠脉狭窄＜70%患者的A、β及A×β无明显变化(P＞0.05).结论 PCI可以有效改善病变心肌节段的微循环,心肌超声造影能够准确、快速、有效地评价PCI术后心肌再灌注情况.

Clinical study on the myocardial reperfusion after percutaneous coronary intervention using myocardial contrast echocardiography in coronary diseases

Objective To study the quantitative analysis of myocardial reperfusion after percutaneous coronary intervention (PCI) using myocardial contrast echocardiography (MCE) in patients with coronary diseases. Methods The contrast agent of SonoVue via vein route using contrast pulse sequencing (CPS)MCE were performed in 15 patients with coronary diseases before and after the PCI. The intensity of amplitude (A) ,slope(β), A ×β, the contrast arrival times (AT) and the arrival peak times (TTP) were calculated with the autotracking contrast quantification software. Results Clear images of the left ventricle were well displayed in all the patients. There were satisfied images in the normal perfusion area of the myocardium,but not in the abnormal. AT,TTP and A ×β were significantly different between the abnormal and the normal perfusion area ( P ＜0. 05). The myocardial reperfusion significantly increased in the group that the coronary stenosis was greater than 70% after PCI( P ＜0. 05). There was no change in the group that the coronary stenosis was less than 70% ( P ＞ 0.05). Conclusions PCI can efficiently improve the myocardial microcirculation. MCE can accurately, rapidly, and efficiently reveal the reperfusion status of myocardium after PCI.