实时三维超声心动图在左前降支病变急性心肌梗死患者PCI术后疗效评价中的应用

Evaluation of outcome after percutaneous coronary intervention by real time three-dimensional echocardiography in AMI patients with lesions in LAD coronary

目的探讨实时三维超声心动图(RT-3DE)评价冠状动脉左前降支(LAD)病变的急性心肌梗死(AMI)患者经皮腔内冠状动脉介入术(PCI)术后疗效的临床应用价值。方法应用RT-3DE对LAD病变的AMI行PCI治疗的患者,术前、术后LAD供血节段的容积和功能进行测定,比较其术后与术前的差异,估测LAD的通畅情况。结果术后与术前的比较:术后1周各LAD供血节段的收缩末容积(ESV)、舒张末容积(EDV)和射血分数(EF)均无明显改变;术后1个月各LAD供血节段EF升高、ESV减小(P<0.05),估测LAD通畅性良好,该结果得到冠状动脉造影证实。结论 RT-3DE通过定量测定支架置入前后LAD供血相应节段的容积和功能的改变,能够评价支架放置后LAD的通畅情况,可应用于这类患者PCI术后疗效的无创性随访。

Objective To investigate the application of real-time three-dimensional echocardiography（ RT- 3DE） in evaluation of outcome after percutaneous coronary intervention（PCI） in AMI patients with lesions in LAD coronary. Methods LV overall, each segment volume and its function of PCI patients with lesions in LAD coronary before and after operation were determined by RT-3DE. The patency of stents vessel was evaluated by comparing differences between before and after the operation. Results There was no significant difference between each segment EDV, ESV, EF one week after operation and those before operation. One month after operation, stents vascular segment ESV decreased significantly（ P 〈 0. 05 ）, EF increased significantly （ P 〈 0. 05 ）. Conclusions RT- 3DE can evaluate the change of volume and function in segments supplied by LAD after PCI,which can be applied in the noninvasive follow-up of patients with lesion in LAD coronary after PCI.