| 张晓丽,闫媛媛.心肌超声造影对冠心病心肌缺血微循环灌注的评估价值[J].安徽医药,2021,25(8):1533-1536. |
| 心肌超声造影对冠心病心肌缺血微循环灌注的评估价值 |
| Evaluated value of MCE on microcirculation perfusion of coronary heart disease with myocardial ischemia |
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| DOI：10.3969/j.issn.1009-6469.2021.08.013 |
| 中文关键词: 冠心病 心肌超声造影 心肌缺血 微循环灌注 |
| 英文关键词: Coronary heart disease Myocardial contrast echocardiography Myocardial ischemia Microcirculation perfusion |
| 基金项目:河南省医学科技攻关计划项目( 201702312) |
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| 中文摘要: |
| 目的探讨心肌超声造影( MCE)对冠心病心肌缺血的微循环灌注的评估价值。方法选取 2017年 1月至 2018年 12月郑州市中心医院 40例冠心病病人(观察组)及同期年龄相匹配的健康志愿者 20例(对照组)进行 MCE检查，对两组左心室心肌节段微循环灌注进行定量分析，记录其 MECE灌注参数( A值、 β值、 A×β值)。结果观察组、对照组分别纳入 495个、 287个心肌节段，观察组 A值、 β值、 A×β值低于对照组( P<0.05)；观察组中室壁运动异常者 112个，无室壁运动异常者 383个，室壁运动异常组心肌节段灌注参数 A值、 β值及 A×β值均明显小于无室壁运动异常组( P <0.05)。根据冠脉狭窄程度进行分组分析，冠脉狭窄 <50%组、冠脉狭窄 50%~69%组心肌节段 A值、 β值及 A×β值对比均差异无统计学意义( P >0.05)，而冠脉狭窄 70%~ 89%组 A×β值明显小于其冠脉狭窄 <50%组及冠脉狭窄 50%~69%组( P <0.05)且冠脉狭窄 ≥90%组 A值、 β值及 A×β值均明显小于其他各冠脉狭窄程度组( P <0.05)。 ROC曲线分析显示， A×β值预测重度冠，脉狭窄(狭窄 ≥70%)的曲线下面积为 0.812(95%CI:0.786~0.842)，截断值为 1.06 dB/s，敏感度为 86.7%，特异度为 80.5%。结论 MCE可定性、定量评价冠心病心肌缺血的微循环灌注情况，显示冠脉狭窄所造成左室心肌微循环损伤程度。 |
| 英文摘要: |
| Objective To explore the evaluated value of myocardial contrast echocardiography (MCE) on microcirculation perfusionof coronary heart disease with myocardial ischemia.Methods MCE examination was performed on 40 patients with coronary heart disease (observation group) and 20 healthy volunteers of matching age (control group) in Zhengzhou Central Hospital form January 2017 toDecember 2018, and quantitative analysis was performed on microcirculation perfusion of left ventricular myocardial segments, and theMECE perfusion parameters (A value, β value, A×β value) were recorded.Results Totally 495 and 287 myocardial segments were included in observation group and control group respectively, and the A value, β value and A×β value in observation group were lowerthan those in control group (P<0.05). There were 112 patients with abnormal ventricular wall motion and 383 without abnormal ventricular wall motion in observation group, and the myocardial segment perfusion parameters of A value, β value and A×β value in abnormalventricular wall motion group were significantly lower than those in non-abnormal ventricular wall motion group (P<0.05). According tocoronary stenosis degree for grouping and analysis, there were no significant differences in the A value, β value and A×β value betweencoronary stenosis <50% group and 50%-69% coronary stenosis group (P>0.05), and the A×β value in 70%-89% coronary stenosis group was significantly lower than that in coronary stenosis <50% group and 50%-69% coronary stenosis group (P<0.05), and the A value, β value and A×β value in coronary stenosis ≥90% group were significantly lower than those in other coronary stenosis groups (P< 0.05). ROC curve analysis showed that the area under the curve, cutoff value, sensitivity and specificity were 0.812 (95% CI: 0.7860.842), 1.06 dB/s, 86.7% and 80.5% for A×β value in predicting severe coronary stenosis (stenosis ≥70%).Conclusion MCE can qualitatively and quantitatively evaluate the microcirculation perfusion of coronary heart disease with myocardial ischemia, and showthe left ventricular myocardial microcirculation injury caused by coronary stenosis. |
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