心肌声学造影在经皮冠脉成形术中的应用

Application of myocardial contrast echocardiography(MCE) in percutaneous transluminal coronary angioplasty (PTCA)

为探讨心肌声学造影（MCE）在经皮冠状动脉成形术（PTCA）中的应用价值，对14例冠心病人于PTCA术前后经冠状动脉完成MCE，观察心肌影象增强计分，心肌灰阶峰值强度（PI）和心肌节段半径缩短率（D％）等指标的变化。结果：心绞痛病人20个心肌节段术前有7个节段MCE计为1分者，术后仍为1分，术前13个节段为0．5分者术后有8个节段升级为三分，PI及△D％均有相应改善（P＜0.01）；7例心肌梗塞病人共分析了16个心肌节段，术前有12个节段MCE计分为0者，术后有9个节段的MCE计分升级，PI及△D％也得到改善，提示有存活心肌。联合观察3项指标可从心肌灌注水平评价PTCA效果。

To evaluate the clinical value of MCE used in PTCA MCE were performed intracoronary in 14patients with coronary artery disease (7 MI,7 angina pectoris) before and after successful PTCA. Imageswere analyzed with indexes of myocardial perfusion score (1, 0. 5, 0),peak intensity of myocardial grey(PI)and percentage of segmental shortening (D% ). The results showed that all segments with the score 0. 5be fore PTCA improved significantly after PTCA both in MI and angina patients. Nine of the twelve seg-ments with the score 0 before PTCA in MI advanced to score 0. 5 or 1. Both PI and D% increased in thesame area. This study suggested that MCE can be used to evaluate the results of PTCA and detect hiber-nating myocardium from the myocardium perfusion point of view.