实时三维超声心动图定量分析经皮冠状动脉介入治疗前后左心功能变化的研究

Study on the change of left ventricular function evaluated by real-time three-dimensional echocardiography before and after percutaneous coronary intervention for patients with coronary heart disease

目的探讨实时三维超声心动图(RT-3DE)技术定量分析冠心病患者经皮冠状动脉介入治疗(PCI)前后左心功能变化的价值。方法选取76例经皮冠状动脉造影证实的冠心病患者进行PCI手术,于术前及术后1个月行RT-3DE检查,并对其测量的结果进行对比分析。另选择68例健康者作为对照组。结果 PCI术后左心室局部收缩末期容量(RESV)、左心室局部舒张末期容量(REDV)降低,左心室局部射血分数(REF)、左心室整体射血分数(EF)、左心室局部心搏量(RSV)明显升高(P<0.05)。牛眼图中病变节段数较术前减少,部分节段心功能得以改善(P<0.05)。结论 PCI术后左心室局部心肌收缩能力和射血能力较术前增强,实时三维超声心动图能定量反映PCI术前后左心室节段心功能变化,从而为评价冠心病患者的PCI疗效提供了一种新的方法。

Objective To assess the value of real- time three- dimensional echocardiography（RT-3DE） in the evaluation of left ventricular function before and after percutaneous coronary intervention for patients with coronary heart disease（CHD）.Methods RT- 3DE was performed in 76 patients with coronary heart disease who accepted PCI treatment successfully at the time point before and 1 month after PCI.These parameters were respectively compared.Another 68 normal healthy subjects were selected as control group.Results 1 month after PCI,the values of REF,EF and RSV were increased,however,thevalues of REDV and RESV were decreased significandy（P 〈0.05）.In the illustration of the bull’s eye,the numbers of lesion segment reduced and the parameters of regional heart functionimproved after PCI（P 〈 0.05）.Conclusions After PCI,the regional contractility and ejection ability ofleft ventricle were strengthened.RT- 3DE can assess the changes of regional heartfunction resulted from PCI quantitatively,which providing another useful modality for evaluating the effect of PCI on CHD patients.