中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2012年
11期
1613-1615
,共3页
血管成形术,经腔,经皮冠状动脉%心肌再灌注%冠状动脉疾病
血管成形術,經腔,經皮冠狀動脈%心肌再灌註%冠狀動脈疾病
혈관성형술,경강,경피관상동맥%심기재관주%관상동맥질병
Angioplasty,transluminal,percutaneous coronary%Myocardial reperfusion%Coronary disease
目的 探讨经皮冠状动脉介入术(PCI)对冠心病( CHD)患者心肌微循环灌注的影响.方法 经冠状动脉造影证实有冠状动脉狭窄的冠心病患者42例,在行PCI术前后均进行经静脉心肌声学造影(MCE)结合腺苷负荷检查,通过心肌显影程度定量判断冠状动脉微循环灌注情况并记录其图像,将PCI治疗前后心肌声学造影结果进行对比分析,评价PCI手术前后心肌微循环灌注情况,以便判断PCI手术疗效,估计患者预后.结果42例患者中39例患者成功完成PCI术,病变血管全部开通,重复造影示TIMI血流3级；灌注异常心肌节段治疗后局部所有毛细血管横截面积之和[A=(15.46±3.27)分]、血流速度[β=(0.75±0.16)分/s]、心肌血流量[A·β=(12.00±4.51)分2/s]均较治疗前[A=(6.68±1.76)分、β=(0.40±0.12)分/s、A·β=(2.82±1.38)分2/s]明显增加(t=37.25、27.58、30.65,均P＜0.05).3个月后随访,射血分数较治疗前明显增加(t=13.77,P＜0.01),室壁运动记分指数较治疗前明显下降(=8.75,P＜0.01).相关分析显示,PCI术后A、β、A·β相关性较强(均P＜0.01).结论 PCI术可有效改善心肌梗死患者心肌组织微循环灌注,尽早行PCI术,可以挽救梗死区的缺血心肌,改善左心室功能.
目的 探討經皮冠狀動脈介入術(PCI)對冠心病( CHD)患者心肌微循環灌註的影響.方法 經冠狀動脈造影證實有冠狀動脈狹窄的冠心病患者42例,在行PCI術前後均進行經靜脈心肌聲學造影(MCE)結閤腺苷負荷檢查,通過心肌顯影程度定量判斷冠狀動脈微循環灌註情況併記錄其圖像,將PCI治療前後心肌聲學造影結果進行對比分析,評價PCI手術前後心肌微循環灌註情況,以便判斷PCI手術療效,估計患者預後.結果42例患者中39例患者成功完成PCI術,病變血管全部開通,重複造影示TIMI血流3級；灌註異常心肌節段治療後跼部所有毛細血管橫截麵積之和[A=(15.46±3.27)分]、血流速度[β=(0.75±0.16)分/s]、心肌血流量[A·β=(12.00±4.51)分2/s]均較治療前[A=(6.68±1.76)分、β=(0.40±0.12)分/s、A·β=(2.82±1.38)分2/s]明顯增加(t=37.25、27.58、30.65,均P＜0.05).3箇月後隨訪,射血分數較治療前明顯增加(t=13.77,P＜0.01),室壁運動記分指數較治療前明顯下降(=8.75,P＜0.01).相關分析顯示,PCI術後A、β、A·β相關性較彊(均P＜0.01).結論 PCI術可有效改善心肌梗死患者心肌組織微循環灌註,儘早行PCI術,可以輓救梗死區的缺血心肌,改善左心室功能.
목적 탐토경피관상동맥개입술(PCI)대관심병( CHD)환자심기미순배관주적영향.방법 경관상동맥조영증실유관상동맥협착적관심병환자42례,재행PCI술전후균진행경정맥심기성학조영(MCE)결합선감부하검사,통과심기현영정도정량판단관상동맥미순배관주정황병기록기도상,장PCI치료전후심기성학조영결과진행대비분석,평개PCI수술전후심기미순배관주정황,이편판단PCI수술료효,고계환자예후.결과42례환자중39례환자성공완성PCI술,병변혈관전부개통,중복조영시TIMI혈류3급；관주이상심기절단치료후국부소유모세혈관횡절면적지화[A=(15.46±3.27)분]、혈류속도[β=(0.75±0.16)분/s]、심기혈류량[A·β=(12.00±4.51)분2/s]균교치료전[A=(6.68±1.76)분、β=(0.40±0.12)분/s、A·β=(2.82±1.38)분2/s]명현증가(t=37.25、27.58、30.65,균P＜0.05).3개월후수방,사혈분수교치료전명현증가(t=13.77,P＜0.01),실벽운동기분지수교치료전명현하강(=8.75,P＜0.01).상관분석현시,PCI술후A、β、A·β상관성교강(균P＜0.01).결론 PCI술가유효개선심기경사환자심기조직미순배관주,진조행PCI술,가이만구경사구적결혈심기,개선좌심실공능.
Objective To evaluate the effect of percutaneous coronary intervention(PCI) on myocardial perfusion in coronary heart.Methods Fourty-two patients with coronary heart disease who were confirmed to have coronary artery steonsis by the coronary angiography were selected.They were checked by myocardial contrast echocardiography of intravenous before and after treatment by PCI.Then we determined quantitatively the perfusion of coronary microcirculation based on the extent of myocardial imaging and recorded it images.The myocardial contrast echocardiography result was compared before and after treatment by PCI for evaluating the situation of myocardial perfusion and effect of PCL So we can estimte the patients' prognosis.Results There were 39 eases of 42 patients with PCI that their lesion vascular were all opening and unblocked.Repeated radiography showed that their TIMI blood flow was the third level.The partial cross sectional area of all the capillaries [A =15.46 ± 3.27) min] blood flow velocity [β =(0.75 ±0.16)min/s],and myocardial blood flow volume[A - β =(12.00 ±4.51 ) min2/s] dependent on myocardial segments all increased more significantly than those before the PCI[A =(6.68 ± 1.76) min,β =(0.40 ± 0.12) min/s、A · β =(2.82 ± 1.38 ) min2/s] (t =37.2527.58、30.65,P ＜ 0.05 ).After PCI three months the EF value of follow-up patients was increased mote than that of before PCI (t =13.77,P ＜ 0.01 )but the scoring index of ventricular wall motion was decreased more than that of before PCI ( t =8.75,P ＜ 0.01 ).Correlation analysis showed that after PCI A,β,A · β all had a strong correlation ( every P ＜ 0.01 ).Conclusion PCI could effectively improve the situation of myocardial perfusion in myocardial infarction patients.It could save ischemia myocardial in infarction field and also improve the function of left ventricular if patients implemented PCI operation as soon as possible.
