CAJ | 학술논문

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 FloMap Ⅱ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(DSVR)、近远端血流速度之比(P／DVR)、冠脉血流储备(CFR)。其中10例同时有PTCA前后和支架后的测值。结果 21支冠脉的直径狭窄率为(81.2±14.4)％。PTCA前、PTCA后、植入支架后狭窄近端APV差别无显著意义(P＞0.05)。PTCA后狭窄远端APV显著增加(P＜0.05)，植入支架后APV进一步增加(P=0.01)。PTCA前后P／DVR差别无显著意义，但植入支架后则明显下降(P＜0.05)。高峰APV在PTCA后非常显著增加(P＜0.01)。植入支架后增加极显著(P＜0.01)，狭窄远端的CFR术前较术后明显增高(P＜0.05)，与支架后比较P＜0.01。与PTCA后比较，放置支架后狭窄远端APV、P／DVR、CFR的差别均无显著意义，但高峰APV有明显提高(P＜0.01)。结论冠脉内血流速度描记技术可用于PTCA及支架植入术中评价治疗效果。
목적응용관상동맥내다보륵혈류속도묘기기술，평개경피관상동맥구낭확장술(PTCA)급지가식입술대관맥혈류저비적영향。방법대21지(18례)유협착병변적관상동맥진행PTCA술，기중16지관맥PTCA술후식입지가。재PT-CA전후화지가식입술후，채용Cardiometric FloMap Ⅱ혈관강내다보륵혈류속도묘기의화다보륵도사，측량협착근단화원단적평균봉치류속(APV)、서장기여수축기류속비(DSVR)、근원단혈류속도지비(P／DVR)、관맥혈류저비(CFR)。기중10례동시유PTCA전후화지가후적측치。결과 21지관맥적직경협착솔위(81.2±14.4)％。PTCA전、PTCA후、식입지가후협착근단APV차별무현저의의(P＞0.05)。PTCA후협착원단APV현저증가(P＜0.05)，식입지가후APV진일보증가(P=0.01)。PTCA전후P／DVR차별무현저의의，단식입지가후칙명현하강(P＜0.05)。고봉APV재PTCA후비상현저증가(P＜0.01)。식입지가후증가겁현저(P＜0.01)，협착원단적CFR술전교술후명현증고(P＜0.05)，여지가후비교P＜0.01。여PTCA후비교，방치지가후협착원단APV、P／DVR、CFR적차별균무현저의의，단고봉APV유명현제고(P＜0.01)。결론관맥내혈류속도묘기기술가용우PTCA급지가식입술중평개치료효과。
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.