脉冲组织多普勒超声心动图在冠心病的诊断及介入治疗评估中的应用-心血管内科学专业毕业论文.docxVIP

3．将11例接受冠脉介入性治疗(PTCA／支架)者术后4～9天部 3．将11例接受冠脉介入性治疗(PTCA／支架)者术后4～9天部 分PW—DTI参数与术前对照，发现受治冠脉相关节段(39个)的vs (PO．05)、Ve(PO．01)、VTIe(P0．01)术后较术前有增加， VTIs无明显变化；两二尖瓣环(22位点)上述4参数前后无显著差 异。 4．DT]结合DSE进行37例试验：不良反应发生率48．56％，均不 严重。有83．78％达130 u g／kg／mm剂量阶段(6min／阶段)。27．03％ 达预期心率。作冠脉造影者9例，4例冠脉病变者2例DSE(+)，5 例大致正常者4例DSE(一)，DSE的预测总准确性66．67％。作TMET 者2l例，4例(+)者3例DSE(+)，17例TMET(一)者16例DSE (一)，DSE与TMET符合率90．48％。对其中14例达≥30 p-g／kegmin Vs、Ve是心肌缺血的可靠而有效的指标，分别反映心肌内在的收缩、 舒张功能，以反映舒张功能的Ve更具诊断力；PW—DT]这一反映局 部心肌功能的敏感方法证实病变冠状动脉接受介入治疗后短期内其 相关节段的收缩、舒张功能均有改善，且舒张功能改善更显著： PW—DTI结合DSE检测多个室壁运动是安全可行的，有一定诊断价值， Vs、Ve是DSE主要观测指标，而以Vs更重要。 关键词：脉冲组织多普勒 超声心动图 冠心病 再灌注 多巴酚丁胺 pl}一钾i的睦鼋 pl}一钾i的睦鼋 Application of Echocardiographic Pulsed-Wave Tissue Doppler Imaging in Diagnosis of Coronary Artery Disease and Evaluation of Coronary Interventional Therapy Tissue Doppler imaging(DTI)is all ultrasonic technique that can be applied to analyse myocardial motion 0biectively and quantitatively With pulsed．waVe DTI(PW．DTI)myocardial motion velocity can be directly measured In this study analysis of longitudinal left ventriculur walI motion was performed to predict coronary artery disease(CAD)．evaluate coronary interventional therapy,and assess feasibility of dobutamine echocardiography(DSE)combining with PW．DTl Eight sample sites were selected at septal(irmer)and lateral(outer)mitral annulus and mid—points of septal．1ateral，posterior,inferiot，anterior and anteroseptal wall The main results were： 1．PW．DTI parameters were measured in 52 nol-mal subjects Peak early diastolic velocity(Ve)in all sites was not correlated to heart rate(HR)There were weak correlations between peak systolic velocity(Vs)and H艮peak Iate diastolic velocity(Va)and HR in half of the sites Theoretically in every one site diastolic velocity-time integral(ⅥIe+vTIa_ⅥIc+a)is equal tO systolic velocity-time integral(VTIs)[P0．90]，linear regression equation was vTIe十产o 087+0．95VTIs． Wllile in patients witll CAD there WaS discreapancy between VTI㈨and ⅥIs阳0．011． 2 The crite