超声与冠状动脉造影、左室造影的对照研究

目的 :通过超声与冠状动脉 (简称冠脉 )造影、左室造影的对照研究 ,探讨超声检测冠心病的临床价值。　方法 :正常人 2 0例 ,拟行冠脉旁路移植术组 18例 ,观察 :①应用彩色多普勒冠脉血流显像技术 (CAFI)显示并测定冠脉血流脉冲多普勒频谱值。②经超声心动图显示和测定室壁运动和左室射血分数。拟行冠脉旁路移植术组需行冠脉造影和左室造影。　结果 :应用CAFI左前降支 (LAD)的显像率最高。拟行冠脉旁路移植术组 12例与正常人 2 0例应用CAFI测LAD血流脉冲多普勒频谱值间差异非常显著 (P <0 .0 0 1或P <0 .0 1) ,两组间左回旋支的钝圆支、冠脉后降支血流脉冲多普勒频谱值无显著差异 (均P >0 .0 5 )。超声与左室造影对照研究中室壁运动异常的检出无显著差异 (P >0 .0 5 )。 2例单支LAD狭窄 >90 %且无侧支循环建立者 ,超声均发现室壁瘤 ,这 2例超声与左室造影等所测左室射血分数最低。　结论 :本研究显示 ,CAFI能直接观察冠脉血流 ,超声观察室壁节段性运动异常可推测相关冠脉病变 ,左室重构对左心功能影响最为明显

Observations by echocardiography and CAFI compared with coronary arteria angiography and left ventricular angiography on coronary artery disease

Objectives:To investigate clinical value of echocardiography and color Doppler coronary artery flow imaging(CAFI) on coronary heart disease. Methods: The pulse wave Doppler parameters of coronary artery flow by CAFI and ventricular wall motion and left ventricular eject fraction by echocardiography were observed in twenty cases of normal subjects(the controls)and eighteen cases of the patients who would be performed by CABG,and coronary arteria angiography and left ventricular angiography were performed in the cases of the patients. Results:Displaying rate of left anterior descending coronary artery(LAD)in the controls and in the patients was the highest. The pulse wave Doppler parameters measured by CAFI of LAD in 12 cases of the patients were significantly different from those of LAD in 20 cases of the controls( P <0.001 or P < 0.01 ),those of left circumflex coronary artery(LCX),posterior descending coronary artery(PD)in three,six cases of the patients were insignificantly different in tow groups( P >0.05). The number of the cases with abnormal ventricular wall motion in 17 cases by echocardiography was insignificantly different from the number of those in 12 cases by left ventricular angiography( P >0.05). Left ventricular aneurysms were found by echocardiography in two patients with single LAD narrowness>90% and without collateral flow, whose left ventricular eject fractions were the lowest measured by echocardiography and left ventricular angiography. Conclusions:Coronary artery flow can be observed directly by CAFI,relative coronary artery lesions may be inferred from abnormal ventricular wall motion observed by echocardiography,the heart function was affected seriously by left ventricular remodeling.