多普勒组织成像技术对PTCA远期疗效判定的应用价值

Long therapeutic study of doppler tissue imaging on percutaneous coronary angioplasty

目的评价经皮腔内冠状动脉成形术(PTCA)及支架置入术对急性心肌梗死患者左室局部心功能的远期影响。方法对40例择期行PTCA及支架置入术的急性心梗患者,应用脉冲多普勒组织成像(PW-DTI)技术检测术前及术后6个月、12个月室壁梗死区域的DTI指标:收缩期峰值速度(Vs)及时间-速度积分(VTI)、舒张早期峰值速度(Ve)及时间-速度积分(VTI)、舒张晚期峰值速度(Va)及时间-速度积分(VTI)与舒张早期峰值速度/舒张晚期峰值速度(Ve/Va),再与20名健康成人作对照分析。结果急性心肌梗死患者术前左室局部舒缩功能指标较对照组显著降低,表现为梗死区域各室壁Vs及VTI、Ve及VTI和Ve/Va均显著降低(P<0.01);急性心梗患者术后6个月、12个月左室局部舒缩功能较术前明显改善,尤其是术后12个月改善更为显著,表现为梗死区域各室壁Vs及VTI、Ve及VTI和Ve/Va均显著增高(P<0.01)。结论PTCA及支架置入术能改善急性心梗患者远期左室局部心功能,且疗效与时间成正相关。

Objective To evaluate the long effects of PTCA＋Stent on regional left ventricular function in acute myocardial infarction （AMI） patients. Methods 40 patients with AMI who received PTCA＋Stent at selected time were examined by pulsed wave Doppler tissue imaging （PW-DTI）before PTCA, 6 months and 12 months after PTCA. A series of index which including the peak motion velocities（V） and the TI at systole phase （S）, early diastohc phase （E） and late diastolic phase （ A ） and the conventional Doppler diastolic parameters （E/A） were measured in all patients and 20 normal individuals. Results Compared with healthy control group,Vs and VTI,Ve and VTI, and Ve/Va had decreased significandy in the patients group before PTCA （P〈0.01）. The value of these indexes had increased obviously in the patients group 6 months and 12 months after PTCA （P〈0.01）. In addition, there were more significant increases in the patients group 12 months after PTCA. Conclusion PTCA＋Stent can imt）rove regional left ventrieular function , the better effects to oatients with AMI were notable after longer time.