经胸多普勒血流显像检测介入治疗前后冠状动脉血流变化及其临床价值

目的探讨经胸超声心动图冠状动脉彩色多普勒血流显像（TTE—CDFI）检测经皮冠状动脉介入治疗术（PCI）前后冠状动脉左前降支（LAD）血流变化及临床价值。方法选择48例LAD病变且进行PCI的冠心病者，应用TTE-CDFI观察PCI手术前后LAD血流变化。观察方法与指标：在3个改良标准切面水平检测LAD中远段、穿隔支和心尖部血流频谱，测定各点收缩期血流峰值速度（SPV）、舒张期血流峰值速度（DPV），收缩期流速时间积分（VTIs）、舒张期流速时间积分（VTId），对比观察PCI手术前后冠状动脉血流频谱参数变化。结果PCI术后SPV、DPV、VTIs和VTId的测值高于PCI术前（P〈0．05或P〈0．01）；以PCI手术前后心肌梗死溶栓治疗分级（TIMI）血流〈1级与≥2级分组，后组的各项超声指标测值高于前组（P〈0．05或P〈0．01）。结论TTE-CDFI检测LAD各段PCI前后血流频谱变化可较好评价PCI的疗效，可用于PCI术后的随访。

Clinical Values of Transthoracic Doppler Echocardiography to Assess Coronary Flow Alteration before and after Coronary Stenting in Patients with Coronary Disease

Objective To evaluate clinical values of transthoracic echocardiography with coronary color-coded Doppler flow imaging(TTE-CDFI) to detect the change of blood flow of coronary arteries in patients with coronary disease before and after percutaneous coronary intervention(PCI). Methods Forty-eight patients with coronary artery disease of left anterior descending branches(LAD) who underwent a successful PCI were included in this study. The Doppler flow parameters including systolic peak velocity(SPV), diastolic peak velocity(DPV), systolic velocity-time integrate(VTIs) and diastolic velocity-time integrate(VTId) from mid-distal LAD, trans-septal branches(TSB) and apical vessels(AV) were determined by using TTE-CDFI and the measurements were compared pre- and post-PCI. Results Comparing with those before PCI, the Doppler-derived parameters of VTLs ,VTLd , VTIs and VTId were significantly increased (P<0.05). The measurements of the parameters in the group of thrombolysis in myocardial infarction(TIMI) 2 were markedly higher than those in the group of TIMI 1(P<0.05). Conclusion TTE-CDFI detecting the alteration of coronary flow is useful for assessing efficacy of PCI and following up the outcomes of PCI.