经皮冠状动脉内多普勒超声技术对冠状动脉血液动力学的研究

目的 :评价冠状动脉 (冠脉 )内多普勒血流钢丝测量冠脉血流速度和血流储备 (CFR)的应用价值。　　方法 :在 2 1例冠脉狭窄患者 (冠脉狭窄组 )和 12例正常冠脉者 (对照组 )中 ,利用冠脉内多普勒血流钢丝和冠脉内注射罂粟碱测量了冠脉的血流速度和 CFR。　　结果 :左前降支冠脉狭窄远端的平均最大血流速度、舒张期最大血流速度、舒张期与收缩期流速比值和 CFR均显著低于对照组测值。　　结论 :应用冠脉内多普勒超声技术可准确测量正常和冠脉狭窄患者的冠脉血流速度和 CFR,冠脉内注射罂粟碱安全、可靠 ,这一方法的临床应用对冠心病患者冠脉血液动力学的评价提供了可靠的方法。

The Study of Coronary Doppler Flowire on Coronary Flow in Patients with Coronary Artery Disease

Objective:To evaluate the application of Doppler Flowire with intracoronary papaverine for assessment of coronary flow in patients with coronary artery disease. Methods:Doppler Flowire was used for measurement of coronary flow velocity and coronary flow reserve (CFR) in 12 angiographically normal coronary arteries (N) and in 21 segments (C) distal to significantly stenosed arteries of left arterior descending branch. Results:The average peak velocity (APV),diastolic peak velocity (DPV),diastolic/systolic peak velocity ratio (DSVR) and CFR in group C were significantly lower than those in the nondiseased coronary arteries (p<0 05).Intracoronary injection of papaverine could produce intense,reliable and rapid acting vasodilation of the coronary arteriolar bed. Conclusion:The use of intracoronary Doppler Flowire and papaverine to measure the coronary flow velocity and the maximal flow reserve capacity of individual coronary vessel provides a new way to study the coronary circulation during cardiac catheterization in patients with coronary artery disease.