心肌背向散射积分在冠心病经皮冠状动脉介入术前后的变化及意义

Clinical meaning of coronary artery disease by integrated backscatter parameters before and after percutaneous coronary intervention

目的:探讨心肌背向散射积分(IBS)参数在冠心病经皮冠状动脉介入治疗术(PCI)前后变化的意义。方法:用二维超声及心肌背向散射联机分析技术,观测18例冠心病患者室壁运动计分指数(WMSI),左室射血分数(EF)及前间隔(中段、基底段)、后壁(中段、基底段)、前壁(中段)、下壁(中段)、后间隔(中段)7个节段IBS参数在PCI前及PCI术后2周、PCI术后3个月变化的情况及其相互关系。结果:PCI术后EF、WMSI与术前相比差异有显著性(P<0.05鄄0.01),PCI术后2周和3月EF,WMSI差异有显著性(P<0.05)。存活节段:在术前、术后2周、术后3个月相比:背向散射积分变异幅度(CVIB)、及其变异度(CVIB%)术后明显增高(P<0.01),标化平均背向散射积分(AII%)逐渐减少(P<0.01),术后2周与术后3个月相比差异无显著性(P>0.05)。结论:PCI术后存活节段IBS参数比室壁运动恢复快,故可更早地了解异常节段局部心功能恢复情况,为临床选择合理的治疗方案提供重要依据。

Objective: To discuss the changes of the parameters of integrated backscatter(IBS), wall motion pre-operation and post-operation of the patients with coronary artery disease(CAD). Methods:To observe the changes of wall motion score indice (WMSI), ejection fraction(EF), IBS parameters in 7 segments[anterior septum(MID, BASAL), posterior wall(MID, BASAL), anterior wall(MID),inferior wall(MID) and posterior septum(MID)] among pre-percutaneous coronary intervention(PCI), PCI(2W), PCI(3M) and to understand the correlations each other. Results: EF and WMSI were significantly different between pre-PCI and post-PCI respectively(P < 0.05-0.01); The magnitude of EF after PCI(3M) was higher than that of PCI(2W)(P < 0.05)? However, the number of WMSI after PCI(3M) was lower than that of PCI(2W)(P < 0.05). The magnitudes of CVIB, CVIB% of post-PCI were higher than those of pre-PCI. However, the number of AII% of post-PCI was lower than that of pre-operation. The magnitudes of CVIB, CVIB%, AII% were not significantly different between PCI(2W) and PCI(3M) respectively. Conclusion:The recovery of IBS parameters in viable myocardium after PCI was faster than those of wall motion. Thus, the recovery of regional myocardial function could be known earlier so that the important evidence is provided with selecting reasonable treating solution in clinic.