实时三维超声心动图对冠脉不同狭窄程度心肌缺血的评估

Evaluation of Myocardial Ischemia in Different Degrees Stenosis of Coronary Artery by Real-time Three-dimensional Echocardiography

目的:探讨实时三维超声心动图对冠脉狭窄患者心肌缺血程度的评估价值。方法:冠脉造影诊断的冠心病患者93例,其中轻度狭窄组26例(<50%)、中度狭窄组19例(50%～75%)、重度狭窄组48例(>75%),正常对照组29例。所有入选患者均行实时三维超声检查。结果:与对照组比较,冠心病重度狭窄组17节段容积-时间曲线参数指标——左室16节段、12节段、6节段达最小收缩容积的时间(Tmsv16-SD、Tmsv12-SD、Tmsv6-SD)、最大时间差值(Tmsv16-Dif、Tmsv12-Dif、Tmsv6-Dif)及各自的经心动周期的校正值(Tmsv16-SD%、Tmsv12-SD%、Tmsv6-SD%及Tmsv16-Dif%、Tmsv12-Dif%、Tmsv6-Dif%)显著增加(P<0.05);轻度、中度狭窄组各参数指标无显著性差异(P>0.05)。结论:实时三维超声心动图能定量评估冠脉病变狭窄程度>75%的患者心肌缺血状况,对早期诊断冠心病提供更多的信息。

Objective To evaluate myocardial ischemia in different degrees stenosis of coronary artery by real-time three-dimensional echocardiography in earlier coronary heart disease.Methods According to angiocardiography,the patients with coronary heart disease were ninty-three,among which,26 cases with mild degree stenosis of coronary artery（50%）,19 cases with middle degree stenosis of coronary artery（50%～75%）,48 cases of severe degree stenosis of coronary artery（75%）,and twenty-nine controls.All patient were measured by the real-time three-dimensional echocardiography.Results Compared with the normal group,the parameters（Tmsv 16-SD,Tmsv 12-SD,Tmsv 6-SD ：the time to end-sistolic minimum volume of the left 16 regional,12 regional,6 regional;Tmsv 16-Dif,Tmsv 12-Dif,Tmsv 6-Dif：time interval difference to end-sistolic minimum volume of the left 16 regional,12 regional,6 regional;and correction value by cardiac cycle of respective parameters： Tmsv 16-SD%,Tmsv 12-SD%,Tmsv 6-SD%,Tmsv 16-Dif%,Tmsv 12-Dif%,Tmsv 6-Dif%）of the seventeen segments time-volume curves of the patients with severe stenosis in coronary artery were increased significantly（p0.05）,the parameters of the mild and midlle degrees stenosis of coronary artery have no significant difference（P0.05）.Conclusion The real-time three-dimensional echocardiography can quantitatively assess myocardial ischemia in severious stenosis of coronary artery（75%）,to provide more information for early diagnosis of coronary heart disease.