心肌超声造影结合腺苷负荷测量心肌血流储备的安全性研究

The safety assessment of adenosine stressing combined with myocardial contrast echocardiography in measurement of myocardial perfusion

目的探讨心肌造声造影结合腺苷负荷评价心肌微血管血流储备的安全性及可行性。方法选择30例急性心肌梗死及11例急性冠脉综合征患者,其中36例行冠状动脉介入手术,应用实时心肌超声造影和腺苷负荷超声心动图,对比研究用药前后血压、心率、血氧饱和度及心电图的变化。结果注射超声造影剂过程中及注射后患者血流动力学及心电图均无明显改变;注射腺苷过程中不良反应表现:胸闷27例(65.9%),心悸及头晕8例(19.5%),呼吸困难7例(17.1%),无症状8例(19.5%)。症状均轻微,且停药后很快恢复,无因不良反应而终止检查者。结论心肌超声造影结合腺苷作为一种诊断方法,是安全可行的,具有潜在的临床推广价值。

Objective To explore the safety and efficacy of adenosine stressing combined with myocardial contrast echocardiography （MCE） in evaluation of myocardial microcirculation perfusion. Methods Thirty patients with acute myocardial infarction（AMI） and 11 patients with acute coronary syndrome （ACS） were enrolled in this study, 36 of them underwent percutaneous coronary intervention （PCI） surgery. Real - time adenosine stressing combined with MCE was performed on the patients, and the changes of blood pressure, heart rate, saturation of blood oxygen and electrocardiogram（ECG） were compared before and after medication. Results No adverse effects with hemodynamics and ECG were found, when microbubble contrast agent was injected intravenously. Side effects during adenosine echocardiography included chest discomfort in 27 cases （65.9%）, headaches in 8 cases （ 19.5% ） , dyspnea in 7 cases （ 17. 1% ） , and nonsymptoms in 8 cases （ 19.5% ） . Most symptoms, however, lasted for short time after termination of the infusion. No patient quitted the study for side effects. Conclusion The adenosine stressing MCE is a safe and efficient method for evaluating myocardial perfusion.