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目的用实时心肌超声造影(real-timemyocardialcontrastechocardiography,RT-MCE)定量评价冠状动脉(冠脉)三支病变患者室壁运动和心肌血流灌注之间的关系。方法使用PhilipsSonos7500及S3探头,对32例经冠脉造影证实三支病变的患者经静脉给予SonoVue进行RT-MCE。将左室壁分为17节段,采用QLAB软件进行心肌灌注的定量分析。结果在异常冠脉供血区,有室壁运动异常节段的心肌血流量明显低于无室壁运动异常节段(1.86±1.09和10.82±5.54,P<0.01)。将血供异常但无室壁运动异常的心肌节段按供血冠脉的狭窄程度分为两组:供血冠脉狭窄程度≤70%组共50个节段,供血冠脉狭窄程度>70%组共135个节段。两组间的血管床横截面积(8.26±4.01和9.06±7.69,P>0.05)和心肌血流量值(11.20±10.5和9.07±11.01,P>0.05)差别无统计学意义,但后者的心肌局部血流速度值减低(1.45±0.38和1.05±0.21,P<0.05)。结论在冠脉三支血管病变中,无室壁运动异常区域的心肌血流速度与供血冠脉的狭窄程度有关。RT-MCE定量分析可用于评价冠脉三支病变患者的局部心肌灌注。
Objective To quantitatively evaluate the relationship between ventricular wall motion and myocardial perfusion in patients with three lesions of coronary artery (coronary artery) by using real-time myocardialocardiography contacteriography (RT-MCE). METHODS: SonoVue was used for RT-MCE in 32 patients with three lesions confirmed by coronary angiography using a Philips SonoS7500 and S3 probe. The left ventricular wall was divided into 17 segments, using QLAB software for myocardial perfusion quantitative analysis. Results In the abnormal coronary artery blood supply area, the myocardial blood flow in the segment with abnormal wall motion was significantly lower than that in the non-wall motion abnormality segment (1.86 ± 1.09 and 10.82 ± 5.54, P <0.01). Myocardial segments with abnormal blood supply but no abnormal wall motion were divided into two groups according to the degree of coronary artery stenosis: 50 coronary artery stenosis ≤70%, 70 coronary artery stenosis A total of 135 segments. There were no significant differences in the cross-sectional area of vascular beds between the two groups (8.26 ± 4.01 and 9.06 ± 7.69, P> 0.05) and myocardial blood flow (11.20 ± 10.5 and 9.07 ± 11.01, P> 0.05) Myocardial local blood flow velocity values decreased (1.45 ± 0.38 and 1.05 ± 0.21, P <0.05). Conclusions In the three coronary arteries of the coronary artery, the velocity of myocardial blood flow in the area of non-wall motion abnormalities is related to the degree of coronary artery stenosis. RT-MCE quantitative analysis can be used to evaluate the regional myocardial perfusion in patients with three coronary lesions.