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目的:探讨定量经静脉心肌声学造影(MCE)对冠脉非闭塞性病变经皮冠状动脉介入术(PCI)前后心肌灌注水平的评价。方法:以我科收治的29例行选择性冠状动脉造影术的患者为研究对象,根据造影结果分为A组:血管正常(对照组);B组:血管狭窄程度为75%～90%;C组:血管狭窄程度>90%。所有患者造影前1～3天行MCE检查,19例成功进行PCI治疗患者术后3～5天再行MCE检查。结果:PCI后MCE定量分析显示:B组的各参数值与A组比较均无明显差异;C组中β值和α×β值较A组明显降低(P<0.05)。同组PCI前后心肌灌注的比较:术后B组α值、β值与术前比较无明显差异,但α×β值较术前明显增加(P<0.05);C组的3个参数值α、β和α×β值与术前比较均无明显差异。结论:血管狭窄程度>90%的病变即使在成功PCI后局部心肌灌注水平仍较正常者低,而血管狭窄程度较轻组在成功实施PCI后心肌灌注良好。成功PCI后狭窄程度较轻组心肌灌注水平较术前有一定程度的改善,而狭窄程度较重组心肌灌注水平较术前改善不明显。
Objective: To evaluate the value of quantitative intravenous myocardial contrast echocardiography (MCE) on myocardial perfusion in patients with coronary non-occlusive lesions before and after percutaneous coronary intervention (PCI). Methods: Twenty-nine patients undergoing selective coronary angiography were divided into group A: normal blood vessels (control group); group B: vascular stenosis ranged from 75% to 90%; Group C: stenosis> 90%. MCE was performed 1 to 3 days prior to angiography in all patients, and MCE was performed in 19 patients 3 to 5 days after successful PCI. Results: Quantitative analysis of MCE after PCI showed that there was no significant difference between group B and group A, and the values of β and α × β in group C were significantly lower than those in group A (P <0.05). Compared with the preoperative and postoperative myocardial perfusion: Compared with preoperative, there was no significant difference in α value and β value in group B, but the α × β value was significantly increased (P <0.05). The three parameter values α , Β and α × β values compared with preoperative no significant difference. CONCLUSIONS: The lesions with> 90% vascular stenosis had a lower myocardial perfusion than those with normal myocardial infarction even after successful PCI, while those with mild stenosis had a good myocardial perfusion after successful PCI. Myocardial perfusion in patients with mild stenosis after successful PCI improved to a certain degree compared with that before operation, while the myocardial perfusion in patients with stenosis was not obvious.