经皮冠状动脉介入术后心肌灌注评价方法的比较Comparing evaluative methods on myocardial reperfusion after percutaneous coronary intervention
王红,黄岚,晋军,宋耀明,耿召华,于学军,覃军,赵刚,高云华,刘政,杨莉
摘要(Abstract)：
目的比较经冠状动脉超声心肌声学造影(MCE)与校正的心肌梗死溶栓临床试验(TIMI)帧数计数(CTFC)及冠状动脉血流速度方法对经皮冠状动脉介入术(PCI)后心肌灌注的评价,并探讨相关临床意义。方法68例住院患者根据选择性冠状动脉造影结果,按血管狭窄程度分组A组,正常对照组;B组,血管狭窄75%~95%;C组,血管狭窄>95%;D组,急性血管闭塞。对各病变血管均进行PCI治疗,并恢复TIMI3级血流。采用定量经冠状动脉MCE、CTFC及冠状动脉血流速度方法对术后心肌灌注状况进行检测。其中,经冠状动脉MCE有关定量参数分别为造影剂峰值密度(A)反映心肌血容量;峰值时间(TP)反映心肌灌注速度;曲线下面积(AUC)反映心肌血流量。结果PCI后心外膜血管恢复正常血流的前提下,各狭窄病变血管组CTFC与对照组差异无统计学意义;而闭塞血管组冠状动脉血流速度较对照组低;在MCE检测中,C组的心肌血容量及血流量较对照组低,而D组反映心肌灌注的3个参数值均较对照组差异均有统计学意义。结论经冠状动脉MCE通过多个参数进行定量分析,较其他两种方法能更精确地评价PCI后心肌灌注状况。
关键词(KeyWords)： 超声检查,介入性;冠状血管造影术;心肌再灌注;血管成形术,经腔,经皮冠状动脉
基金项目(Foundation):
作者(Author): 王红,黄岚,晋军,宋耀明,耿召华,于学军,覃军,赵刚,高云华,刘政,杨莉
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