经胸超声心动图检测冠状动脉左前降支狭窄临床应用价值

Clinical value of transthoracic echocardiography in detecting stenosis of left anterior descending coronary artery

目的探讨经胸超声心动图(TTE)无创检测冠状动脉左前降支狭窄的临床应用价值。方法回顾性分析北部战区总医院自2020年12月至2021年1月收治的50例冠状动脉CT或冠状动脉造影显示为左前降支狭窄的患者的临床资料。根据狭窄程度不同,将狭窄率≥50%的患者纳入B组(n=21),狭窄率<50%的患者纳入A组(n=29)。所有患者在接受冠状动脉CT或冠状动脉造影7 d内行TTE,记录左前降支血流信号频谱方式,比较两组的舒张期峰值速度、舒张期平均血流速度、舒张期速度时间积分。结果 50例患者中,46例(A组26例,B组20例;92%,46/50)可记录到左前降支中远段血流速度。B组存在节段性血流五彩混叠,狭窄节段处血流局部加速,狭窄节段远端血流呈现暗红色,血流速度降低,而A组显示为红色或亮红色血流。B组舒张期峰值速度、舒张期平均血流速度、舒张期速度时间积分分别为(0.43±0.28)m/s、(0.31±0.20)m/s、(0.17±0.11)m,均高于A组的(0.27±0.07)m/s、(0.20±0.05)m/s、(0.11±0.03)m,差异有统计学意义(P<0.05)。结论 TTE是一种可靠的无创性检查方法,可快速检测冠状动脉左前降支中、远段的局部血流速度异常,对冠状动脉狭窄进行有效判断。

Objective To discuss clinical value of transthoracic echocardiography(TTE)in detecting stenosis of left anterior descending coronary artery.Methods The clinical data of 50 patients with stenosis of left anterior descending coronary artery revealed by coronary artery CT or coronary angiography were retrospectively analyzed from December 2020 to January 2021.According to the degree of stenosis, patients with stenosis rate ≥50% were included in group B(n=21)and patients with stenosis rate <50% were included in group A(n=29).All patients underwent TTE within 7 days after coronary artery CT or coronary angiography, and the frequency spectrum of blood flow signals in the left anterior descending branch was recorded.The diastolic peak velocity, diastolic mean blood flow velocity, and diastolic velocity time integral were compared between the two groups.Results Of the 50 patients, 46 can be recorded in the middle and distal segments of the left anterior descending ramus.In group B,there was A multicolor mixture of segmental blood flow, with local accelerated blood flow at the stenosis segment, dark red blood flow at the distal end of the stenosis segment and decreased blood flow velocity, while in group A,red or bright red blood flow was shown.Group B diastolic peak velocity, diastolic mean blood flow velocity, diastolic velocity time integral were(0.43±0.28)m/s,(0.31±0.20)m/s,(0.17±0.11)m, higher than those in group A(0.27±0.07)m/s,(0.20±0.05)m/s,(0.11±0.03)m, with statistical significance(P<0.05).Conclusion TTE is a reliable and non-invasive examination method, which can quickly detect the local abnormal blood flow velocity in the middle and distal segments of the left anterior descending coronary artery and effectively judge the coronary stenosis.