超声心动图负荷试验评价冠状动脉再通治疗后心肌缺血

为评价冠心病患者冠状动脉（冠脉）再通治疗后的心肌缺血，对57例冠脉扩张或冠脉搭桥术后有胸痛等症状的病人进行超声心动图多巴酚丁胺或运动负荷试验（DSE／TMX）。结果：DSE／TMX阳性提示心肌缺血者26例，占45．6％，均无严重并发症发生。10例再行冠脉造影，6例DSE／TMX阳性者中，5例相应血管严重狭窄，1例相应血管轻微病变，4例DSE／TMX阴性者中，2例冠脉造影示相应血管亦无严重狭窄。表明：DSE／TMX可用于筛选划分需再次行血管再通治疗及需加强扩张冠脉药物治疗的病人，也可用于筛选冠脉再通治疗后心肌缺血的低危病人群。DSE／TMX是安全有效的心肌缺血评价手段。

Stress echocardiography assessing myocardial ischemia after coronary artery revascularization

To assess myocardial ischemia after coronary artery revascularization (CAR ), we studied 57 patients suffering from chest pain after percutaneous translufornal coronary angioplasty (PTCA)/coronary artery bypass graft (CABG)by dobutandne or exercise stress echocardiography (DSE/TMX). Male 36, female 21 with the mean age of 57. Results: There were 26 patients with positive result of DSE/TMX showing myocardial ischemia (45. 6% ). There were no serious complication. Coronary angiogram was done in 10 patients. The result showed that there were 5 patients with positive DSE/TMX and severe relevant coronary artery stenosis ,1 patient with positive DSE/TMX and minor relevant coronary artery stenosis and 2 patients with negative DSE/TMX and minor relevant coronary artery disease. Two more patients with old myocardial infarction had obvious coronary artery stenosis,but DSE/TMX was negative and fixed segmental wall motion abnormalities were noted. Conclusion:In patients after CAR,DSE/TMX is a safe and effective method to assess myocardia1 ischemia. It can be used to screen the group of patients who need repeat revascula rization or treat cornary artery spasm with drugs. It also can be used to screen the low risk of pa tients with myocardial ischemia.