组织多普勒成像对经皮冠状动脉腔内成形术的疗效评价

Therapeutic evaluation of DTI-PW on percutaneous coronary angioplasty

目的 使用脉冲组织多普勒成像(DTI -PW )评价经皮腔内冠状动脉成形术的疗效评价。方法 对2 6例心绞痛患者均于选择性冠状动脉造影术前、术后行二维超声心动图及组织多普勒成像检查,记录心肌各节段及二尖瓣环的运动速度频谱,测量收缩期(S)、舒张早期(E)、舒张晚期(A)峰值速度(V )及时间速度积分(TI) ,计算内外膜峰值速度差(ΔV)、内外膜峰值速度阶差(MVG)和E/A比值,测量等容收缩期(IVC)、等容舒张期(IVR )心肌运动速度频谱持续时间。结果 术前室壁基段、中段及二尖瓣环的S峰值V与正常组差异无显著性,S峰值的TI、E峰值的V及TI明显低于正常组,E/A比值下降;ΔV减低,MVG显著降低;IVC、IVR时限延长。术后室壁及二尖瓣环S、E峰值V及TI较术前提高,但仍低于正常,MVG增加(P <0 .0 1或0 .0 5 )。结论 DTI -PW参数能实时、早期、准确、反复、定量地分析左室局部与整体舒张和收缩功能,从而为判断心脏病介入治疗的效果提供一个新的无创性定量指标。

Objective To study the therapeutic evaluation of DTI-PW on percutaneous transluminal coronary angioplasty. Methods Two-dimension echocardiography and DTI-PW were given to 26 patients with angina pectoris. Spectra of movement speeds of the segments of cardiac muscle and biscuspids were recorded before and after the selective coronary arteriography for the measurement of the peak burning (V) and the TI at systole (S), Early diastolic phase (E) and late diastolic phase (A) and the speed differences of the intimal peak value and adventitial peak value(ΔV), ratio of MVG and E/A and the spectra duration of cardiac muscle movement speed at isovolumetric contraction phase (IVC) and constant volume diastolic (IVR). Results There showed no significant differences in the S values of the base segment and middle segments of the locular wall and the bicuspids before operation. The TI of the S value and the V and TI of the E value were much lower than those of the control group; there was a fall in the E/A ratio; a decrease in ΔV and the decrease in the MVG was obvious; The IVC and IVR periods were extended. The locular wall and the S and E values of the biscuspids as well as the TI after operation were higher than those before operation, still lower than normal level though. There was an increase in the MVG (P<0.01 or 0.05). Conclusion DTI-PW parameters could be used in the analysis of the partial and overall diastolic as well as the function of contraction in the ventricular sinister which required real time, early, veracious, repeated and quantitative effects and therefore was a new determinant for non-traumatogenic detection in interventional therapy for heart diseases.