心肌造影负荷超声心动图检测X综合征患者心肌血流量

The Study of Myocardial Contrast Stress Echocardiography in Detecting Myocardial Blood Flow of Syndrome X

目的:评价心肌造影负荷超声心动图(MCSE)检测X综合征患者心肌血流量(MBF)的临床应用价值。方法:选择经冠状动脉造影(CAG)的住院患者27例,分为X综合征组8例;对照组19例,均行经静脉心肌造影(MCE),其中对照组7例、X综合征组8例行经静脉多巴酚丁胺负荷试验(DST)后重复MCE。检测心肌显影峰值密度(PI),闪烁显像后即刻至达到峰值密度的时间(TP),该节段的MBF[MBF=(PI/TP)·PI]。结果:对照组心肌声学显影的PI与X综合征组相比差异无统计学意义(P>0.05),X综合征组TP较对照组长(P<0.05),X综合征组MBF较对照组低(P<0.01)。对照组负荷前、后MCE示,应用多巴酚丁胺后PI较负荷前有增加趋势,负荷后TP较负荷前有缩小趋势,但差异无统计学意义(P>0.05),负荷后MBF较负荷前明显增加(P<0.01)。X综合征患者组负荷前、后心肌造影显示,经静脉DST前后PI差异无统计学意义(P>0.05),负荷前后TP和MBF差异均无统计学意义(P>0.05)。结论:实时MCE、MCSE能够定量分析MBF,对检测微循环灌注异常的X综合征患者具有临床应用价值。

Objective：To evaluate clinical value of myocardial contrast stress echocardiography （MCSE） in deeting myocardial blood flow （MBF） of patients with syndrome X. Methods： Twenty-seven patients, who were confirmed by angiography, were included in this study.These patients were divided into syndrome X （8 cases） and control （19 eases） groups. Seven patients in control group and 8 patients in syndrome X group were selected to do the dobutamine stress test （DST）. The peak density （PI）, the time to peak density（TP） and MBF[MBF= （PI/TP）. PI] were detected in selected patients with myocardial contrast echocardiography（MCE）. Results：There was no deference in PI of MCE between the group of syndrome X and control （P 〉 0.05）. There was a longer TP in syndrome X group than that of control （P 〈 0.05）. MBF was lower in syndrome X group than that of control group （P〈 0.01）. In control group, there were no deferences in PI and TP before and after DST （P〉 0.05）, but there was an increasing trend in PI, and a decreasing trend in TP after DST. MBF was significantly larger after DST than that of before DST （P〈 0.01 ）. In syndrome X group, PI, TP, and MBF were no deference between before and after DST （P〉 0.05）. Conclusion：MBF could be analyzed quantitatively by real-time MCE, MCSE. MCE and MCSE have clincal value in detecting abnormal of myocardial microcirculation flow.