数字电影计帧法对冠状动脉狭窄程度的功能性评价

Evaluation of Functional Severity of Coronary Artery Stenosis by Cineframe Count

目的 :通过对经皮冠状动脉腔内成形术 (PTCA)前后病变血管的电影充盈帧数的计测 ,探讨数字电影计帧法对冠状动脉狭窄程度的功能性评价。方法 :选择冠状动脉前降支单支病变择期PTCA患者 (PTCA组 ) 68例 ,同期冠状动脉造影正常者 (对照组 ) 3 8例。用德国西门子Angiostarplus血管造影机 ,以 3 0帧 /秒进行数字电影图像采集。计测PTCA前后冠状动脉左前降支和回旋支的电影帧数 ,并计算前降支与回旋支电影帧数比值 (LAD/LCX)。结果 :病变血管的电影帧数PTCA后显著低于PTCA前 ,有极显著性差异 (P <0 0 1) ,而回旋支的电影帧数PTCA前后无显著变化。PTCA前PTCA组LAD的电影帧数显著高于对照组 ,有极显著性差异 (P <0 0 1) ,PTCA后两者对比无显著差异。PTCA前的电影帧数LAD/LCX显著高于PTCA后 ,有极显著性差异 (P <0 0 1)。结论 :左前降支的电影帧数及LAD/LCX随病变程度的加重而增加。计帧法能够更准确地反映狭窄局部的功能状况。

Objective:To evaluate functional severity of coronary artery stenosis by frame-counting method before and after percutaneous transluminal coronary angioplasty (PTCA). Methods:Sixty-eight patients(Group P) with one vessel disease of left anterior descending (LAD) received PTCA and 38 patients (Group C) without coronary artery disease were comparatively studied. All angiograms were filmed at 30 frames per second. The Frame count (FC) ratio of LAD/LCX was calculated. Results:In group P,pre-PTCA FCs of the diseased vessel was significantly greater than post-PTCA FCs,but there was no significant difference in no-lesion vessel between pre-PTCA and post-PTCA. FCs of the LAD in Group P were significantly greater than that of pre-PTCA in Group C,but there was no difference in FCs of the LAD between the two groups after-PTCA. The FC ratio (LAD/LCX)of pre-PTCA was significant higher than that of post-PTCA. FCs of LAD and the FC ratio (LAD/LCX) increased with the severity of coronary artery stenosis. Conclusion:The frame-counting method can exactly reflect the functional severity of the stenosis part of coronary artery.