摘要
目的利用无创性磁共振(MR)血流测量技术观察冠心病患者在介入治疗前及术后早期冠状动脉血流及血流储备的改善情况。方法选取拟行介入治疗的冠心病患者,在介入治疗前行MR检查,利用流速编码相位对比(VEPC)技术对右冠脉和左前降支近段血流进行测量,分别测量患者静息状态和双嘧达莫静脉注射后的负荷状态下的血流,进而根据公式计算出冠状动脉血流储备(CFR)。在成功介入治疗后,对其中单支病变患者在术后3～7d内重复进行MR检查,对介入治疗前后冠状动脉血流及血流储备的情况进行比较。结果共有29例单支病变的冠心病患者成功接受介入治疗,并完成术前及术后的MR检查,其中左前降支病变16例,右冠脉病变13例。静息血流量:术前为(1.05±0.54)ml/s,术后为(1.27±0.57)ml/s,差异有统计学意义(P<0.05);负荷状态下的血流量:术前为(1.31±0.64)ml/s,术后为(2.35±1.00)ml/s,差异有统计学意义(P<0.01);CFR:术前为(1.28±0.27),术后早期为(1.90±0.40),差异有统计学意义(P<0.01),术后CFR明显增高,但是仍低于前期研究中无狭窄或轻度狭窄的CFR均值。结论冠心病患者在介入治疗术后早期,利用MR血流测量技术可观察到病变血管的血流状态明显改善,CFR增加,但仍未恢复正常。
Objective Non -invasively Magnetic Resonance （MR） flow measurement technique was used to observe the improved conditions of coronary flow and flow reserve （CFR） after interventional therapy. Methods The patients who suffered from coronary heart disease and prepared to receive interventional therapy were enrolled. All the patients underwent MR examination and velocity encoding phase contrast （VEPC） to measure the flow of right coronary artery and proximal segments of the left ascending artery respectively. The flows at rest and stress status with intravenous dipyridamole were determined, and then the CFR was calculated based on the formal. After successfully interventional therapy, the patients with single morbid vessel were underwent MR examination again from 3 to 7 days. The conditions of coronary flow and CFR before and after the intervention were compared. Results There were 29 patients with single morbid vessel who underwent successful intervention therapy and MR examination before and after the intervention, among them 13 whose RCA and 16 whose LAD were involved. The mean rest flow increased from （ 1.05 ± 0. 54） ml/sec in pre - therapy to （ 1.27 ± 0. 57 ） ml/sec in post - therapy （ P 〈 0. 05 ）. The mean stress flow increased from （ 1.31 ±0. 64） ml/sec in pre - therapy to （2. 35 ± 1.00） ml/sec in post therapy （P 〈0.01 ）. And the CFR increased from （ 1.28 ± 0.27 ） to （ 1.90 ± 0. 40） （ P 〈 0. 01 ）. Compared the previous publication result, the CFR value was still lower than the mean values of the normal vessel and mild stenosis of the vessel. Conclusion In the early stage after successful coronary intervention, the MR blood flow measurement can detect remakble improvement of blood flow in the morbid vessel, with CFR increase. However it does not reach to the normal range.
出处
《中国全科医学》
CAS
CSCD
北大核心
2009年第17期1580-1582,1586,共4页
Chinese General Practice
