【摘要】 目的在经皮冠脉介入治疗术(PCI)前后,运用多普勒组织成像(DTI)技术检测小剂量多巴酚丁胺负荷超声心动图(LDDSE)过程中的存活心肌,探讨DTI及LDDSE结合DTI技术识别存活心肌的价值。方法20例冠心病患者均行PCI术,术前1周内,行LDDSE、DTI检查,并于术后2周、术后3个月复查二维超声(2DE)及DTI,测得收缩期室壁运动(S波)的峰值运动速度(Vs),舒张早期室壁运动(e波)的峰值运动速度(Ve)和舒张晚期室壁运动(a波)的峰值运动速度(Va)。结果LDDSE过程中,多巴酚丁胺(Dob)5μg室壁运动计分指数(WMSI)不变,Dob10μg时WMSI下降的异常室壁运动节段共有10个。Dob5μg时与静息相比,Ve增加(P<0.05);Dob10μg与5μg相比,Vs、Va增加(P<0.05)。以PCI术后3个月作为判断存活心肌的时间标准,共有存活节段123个,坏死节段16个。术后2周:存活心肌的Ve较术前增加(P<0.05);术后3个月:存活心肌的Vs、Va较术后2周增加(P<0.05)。结论通过LDDSE结合DTI技术,观察LDDSE过程中及PCI前后心肌舒张功能的变化,可更早发现及提高识别存活心肌的能力。更多还原

【Abstract】 Objective To assess the viable myocardium during low dose dobutamine stress echocardiography(LDDSE) pre and post-percutaneous coronary intervention(PCI)by applying Doppler tissue image (DTI), to detect the value of DTI and LDDSE+DTI in assessing the viable myocardium.Methods Before PCI, LDDSE and DTI were performed on 20 patients with coronary artery disease(CAD) and after PCI 2 weeks and PCI 3 mohths, all patients were examined with 2DE and DTI. The value in detecting viable myocardium was compared among LDDSE, 2DE and DTI.Results WMSI were not changed during LDDSE with Dob 5μg, while there were 10 abnormal segments with Dob 10 μg. Ve value was higher with Dob 5 μg (P<0.05). Compared with Dob 5 μg, Vs and Va were higher(P<0.05) with Dob 10 μg. 2DE of PCI 3 months was regarded as the standard for assessing viable myocardium. There were 123 viable segments and 16 necrosis segments. Ve of PCI 2 weeks was higher than that of pre-PCI, and Vs, Va after PCI 3 months were higher than those of PCI 2 weeks(P<0.05).Conclusion By LDDSE combining DTI, viable myocardium could be more early discovered, the ability of assessing myocardium could be improved by observing the changes of diastole function during LDDSE pre-operation and post-operation.更多还原