赵联璧,邢长洋,杨沛,柴国虎,王海燕,郭万刚,袁丽君.超声心动图观察经皮冠状动脉介入术后心肌缺血再灌注损伤[J].中国医学影像技术,2020,36(1):16~20
超声心动图观察经皮冠状动脉介入术后心肌缺血再灌注损伤
Echocardiographic observation on myocardial ischemia reperfusion injury after percutaneous coronary intervention
投稿时间:2019-05-06  修订日期:2019-12-12
DOI:10.13929/j.issn.1003-3289.2020.01.004
中文关键词:  经皮冠状动脉介入治疗  心肌缺血  心肌再灌注  超声心动描记术
英文关键词:percutaneous coronary intervention  myocardial ischemia  myocardial reperfusion  echocardiography
基金项目:全国博士后创新人才计划科学基金(BX20180377)、唐都医院苗子人才资助基金(2018MZRCXCY)。
作者单位E-mail
赵联璧 空军军医大学唐都医院超声诊断科, 陕西 西安 710038  
邢长洋 空军军医大学唐都医院超声诊断科, 陕西 西安 710038 xingcy@fmmu.edu.cn 
杨沛 空军军医大学唐都医院心内科, 陕西 西安 710038  
柴国虎 空军军医大学唐都医院心内科, 陕西 西安 710038  
王海燕 空军军医大学唐都医院心内科, 陕西 西安 710038  
郭万刚 空军军医大学唐都医院心内科, 陕西 西安 710038  
袁丽君 空军军医大学唐都医院超声诊断科, 陕西 西安 710038  
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中文摘要:
      目的 应用常规超声心动图及二维斑点追踪(2D-STE)技术对经皮冠状动脉介入(PCI)术后心肌缺血再灌注损伤(MIRI)进行观察和评价。方法 收集32例拟接受急诊PCI术的心肌梗死患者,其中15例血管开通后发生临床MIRI(MIRI组),17例未发生MIRI(对照组)。采用常规超声心动图及2D-STE,于术前8 h内及术后2 h内对左心结构、舒张及收缩功能和长轴应变(GLS)进行评价,对比组间及组内术前、术后各超声指标。结果 PCI术前、术后,2组左心内径及室壁厚度差异均无统计学意义(P均>0.05)。术后MIRI组E峰较术前显著降低(P=0.032),E/A显著低于术前(P=0.021),二尖瓣瓣环舒张早期运动速度e显著低于术前(P=0.018),E/e高于术前(P=0.047);对照组舒张功能无显著变化(P>0.05)。MIRI组术后射血分数(ET)无明显变化,GLS显著减低(P<0.05),对照组术后EF及GLS显著升高。结论 PCI术后发生临床MIRI者舒张功能及GLS减低,联合常规超声心动图及2D-STE可对PCI术后MIRI进行评价。
英文摘要:
      Objective To evaluate changes of myocardial ischemia reperfusion injury (MIRI) after percutaneous coronary intervention (PCI) using regular echocardiography and 2D-STE. Methods Thirty-two myocardial infarction patients who would underwent emergency PCI were included, among them 15 demonstrated clinical MIRI after PCI, while the other 17 not. Regular and two-dimensional speckle tracking echocardiography (2D-STE) were performed before (within 8 h) and after (within 2 h) PCI for evaluation on left ventricular structure, diastolic and systolic function and global longitudinal strain (GLS). All the echocardiographic parameters were compared between and within groups. Results There was no significant difference of left heart diameter nor wall thickness between 2 groups before and after PCI (all P>0.05). Patients without MIRI showed no significant change of diastolic function, while those with MIRI showed reduced diastolic function demonstrated by decreased mitral flow velocity and annular velocity in early-diastole (E and e), and increased E/e (P<0.05). The eject fraction (EF) and GLS were significantly improved after PCI in patients without MIRI, whereas no change of EF but reduced GLS was observed in patients with MIRI. Conclusion Patients with clinical MIRI after PCI suffered from reduced diastolic function and GLS. Regular echocardiography and 2D-STE should be combined to examine patients with MIRI after PCI.
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