CAJ | 학술논문

目的应用多巴酚丁胺负荷心肌声学造影方法定量评估冠状动脉慢血流(CSF)对心肌灌注的影响.方法选择因胸痛行冠状动脉造影的患者40例,CSF组与对照组各20例.行静息及多巴酚丁胺负荷状态下心肌声学造影检查,图像脱机分析,应用自动追踪测量软件得出各阶段的曲线,峰值强度A值,曲线斜率β值,心肌血流量(A值×β值)和心肌血流储备(CFR),行统计学分析.同时采集试验各阶段的心电图等资料分析变化.结果 (1) CSF组与对照组静息时的A值[(6.85±2.99) dB比(7.01 ±3.49)dB]、β值[(0.59±0.33)/s比(0.61±0.38)/s]、A值×β值[(3.48±1.46) dB/s比(3.31±0.96) dB/s]差异均无统计学意义(P均＞0.05).(2)负荷状态下,两组β值和A值×β值较静息时明显增加,CSF组的β值明显低于对照组[(0.89 ±0.42)/s比(1.31±0.54)/s,P＜0.01],CSF组的A值×β值低于对照组[(5.82±2.69) dB/s比(8.07±2.76) dB/s,P＜0.05],CSF组的CFR低于对照组(1.82±0.85比2.60±0.98,P＜0.05).(3)两组静息心电图未见异常,负荷状态下CSF组心电图阳性率明显高于对照组(12例比2例,60％比10％,P＜0.01). 结论 CSF患者在多巴酚丁胺药物负荷状态下存在心肌灌注异常.
목적 응용다파분정알부하심기성학조영방법정량평고관상동맥만혈류(CSF)대심기관주적영향.방법 선택인흉통행관상동맥조영적환자40례,CSF조여대조조각20례.행정식급다파분정알부하상태하심기성학조영검사,도상탈궤분석,응용자동추종측량연건득출각계단적곡선,봉치강도A치,곡선사솔β치,심기혈류량(A치×β치)화심기혈류저비(CFR),행통계학분석.동시채집시험각계단적심전도등자료분석변화.결과 (1) CSF조여대조조정식시적A치[(6.85±2.99) dB비(7.01 ±3.49)dB]、β치[(0.59±0.33)/s비(0.61±0.38)/s]、A치×β치[(3.48±1.46) dB/s비(3.31±0.96) dB/s]차이균무통계학의의(P균＞0.05).(2)부하상태하,량조β치화A치×β치교정식시명현증가,CSF조적β치명현저우대조조[(0.89 ±0.42)/s비(1.31±0.54)/s,P＜0.01],CSF조적A치×β치저우대조조[(5.82±2.69) dB/s비(8.07±2.76) dB/s,P＜0.05],CSF조적CFR저우대조조(1.82±0.85비2.60±0.98,P＜0.05).(3)량조정식심전도미견이상,부하상태하CSF조심전도양성솔명현고우대조조(12례비2례,60％비10％,P＜0.01). 결론 CSF환자재다파분정알약물부하상태하존재심기관주이상.
Objective To explore myocardial perfusion of patients with coronary slow flow (CSF) using myocardial contrast echocardiography.Methods Myocardial contrast echocardiography was performed in coronary artery angiography diagnosed CSF patients (n =20) and control patients (n =20).The images at baseline and after low dose dobutamine stress test were analyzed by automatic tracking software and the maximal amplitude score A,the mean ascending slope of the curve β and the product of A × β were measured.The reserve of A × β was also calculated.Electrocardiogram at rest and at each stage of dobutamine stress test was obtained simultaneously.Results At baseline,the A [(6.85 ± 2.99) dB vs.(7.01 ±3.49) dB],β[(0.59±0.33)/s vs.(0.61 ±0.38)/s] and A ×β [(3.48 ±1.46) dB/s vs.(3.31 ±0.96) dB/s] values were similar between CSF group and control group (all P ＞ 0.05).After dobutamine stress test,both β and A × β were significantly increased in two groups.The β [(0.89 ± 0.42)/s vs.(1.31 ± 0.54)/s,P ＜ 0.01] and A × β [(5.82 ± 2.69) dB/s vs.(8.07 ± 2.76) dB/s,P ＜0.05] in CSF group were significantly lower than in control group.Electrocardiogram of all the subjects was normal at rest,but the electrocardiogram positive rate was significantly higher in CSF group than in control group after dobutamine stress test (12％ vs.2％,60％ vs.10％,P ＜ 0.01).Conclusions Dobutamine stress test could induce myocardial perfusion abnormalities in patients with coronary slow flow phenomenon.