心磁图在冠心病患者经皮腔内冠状动脉成型术后随访中的应用

The clinical application of magnetocardiography to the coronary heart disease patients in the follow up for percutaneous transluminal coronary angioplasty

目的探讨心磁图法在冠心病患者经皮穿刺腔内冠状动脉成型术(PTCA)后随访中的临床应用。方法应用德国SQUID公司的7通道心磁图仪,分别检测55例冠心病患者(冠脉造影至少有1支血管狭窄≥50%)在PTCA术前、术后24h、术后1个月和50例健康人的心磁图,比较PTCA术前、术后不同时刻病理性电流区域存在的强度和时间,并分析定量指标异常磁图比(RAM)STT间期中严重异常的心磁图占总磁图数的百分比。结果冠心病组PTCA术前的RAM为(7200±2688)%,对照组为(3922±2531)%,两组差异有显著性(P<0001)。PTCA术前的RAM(7200±2688)%和PTCA术后24h的RAM(6782±2996)%比较差异无显著性(P>005),PTCA术后1月时的RAM(5052±3175)%较PTCA术前有显著改善(P<001)。结论心磁图是PTCA术后效果监测的很有价值的一种无创性随访方法。

Objective To study the clinical application of magnetocardiography(MCG) to coronary heart disease (CHD) patients in the follow up of percutaneous transluminal coronary angioplasty (PTCA). Methods MCG measurements were performed in 55 CHD patients before, 24 hours and one month after PTCA and 50 healthy volunteers by means of the seven channel magnetocardiographic system (MCG7, SQUID AG, Germany). CHD was diagnosed in case of stenosis≥50% in ≥1 vessel. We analyzed the current density distribution maps(CDDM) and magnetic field maps(MFM), and compared the lasting period and intensity of the additional areas before, 24 hours and one month after PTCA during ventricular repolarization. The quantitative indicator was analyzed also. Ratio of abnormal maps(RAM) was the ratio of numbers of severe abnormal maps over total maps. Results RAM of CHD group(72 00±26 88)% before PTCA was much higher than that of the healthy group(39 22±25 31)% ( P <0 001). No significant difference was found in RAM between before (72 00±26 88)% and 24 hours after coronary PTCA (67 82±29 96)%( P >0 05) RAM(50 52±31 75)% of one month after PTCA was much lower than that of before stenting ( P <0 01). Conclusions MCG mapping is a valuable non invasive method of evaluating the effects monitoring the follow up for PTCA.