冠心病支架植入术后超声心肌灌注显像的初步研究

目的初步探究实时超声心肌造影(MCE)评价经皮冠状动脉介入(PCI)术后心肌灌注情况的应用价值。方法 8例因胸痛就诊的临床诊断为冠心病或疑似冠心病患者纳入此项研究。结果 7例患者确诊冠心病,并行PCI治疗。8例患者共记录图像清晰的有效节段为51个,其中7例确诊为冠心病的患者共记录43段。1例患者MCE检查发现2个节段灌注欠佳,但心肌酶谱及心电图检查为阴性,未行PCI治疗。以CAG为标准,MCE对LAD病变的检出率为100%,对LCX病变的检出率为60.0%,对RCA的检出率为66.7%。结论①MCE可以客观的反映PCI术后心肌的再灌注情况;②冠脉造影显示狭窄血管腔<50%的冠脉分布区,也会出现心肌灌注异常,进一步证明实时超声心肌造影可以补充冠脉造影的不足,准确地反映心脏微循环。

The value of myocardial perfusion of coronary heart disease with percutaneous coronary intervention by myocardial contrast echocardiography

Objective To primarily evaluate the value of myocardial perfusion of coronary heart disease with percutaneous coronary intervention(PCI) by myocardial contrast echocardiography(MCE).Methods 8 patients with chest pain who were clinically diagnosed or supposed as CHD were enrolled in the study.Results Epicardial showed well in all cases.51 clear segments were recorded in all patients:43 of them were recorded in those 7 patients Who underwent coronary angiography(CAG).8 segments were recorded in that one without PCI treatment.2 of 8 segments showed perfusion defect.Using CAG as gold standard,the detection rate of LAD,LCX and RCA was 100.0%,60.0% and 66.7%.Concluction MCE is an ideal imaging tool for the assessment of myocardial reperfusion for the patients post-PCI;MCE accurately reflects the decrease in myocardial perfusion while CAG showed the degree of stenosis <50%;The authors believed that MCE could be a very good complement to using the CAG in clinical practice,accurately reflect the myocardial microcirculation.