摘要
目的：应用多普勒超声心动图评价经皮冠状动脉内支架植入术后左室舒张功能的变化，以探讨冠脉内支架植入术对左室舒张功能的影响。
方法：应用HPSonos5500型彩色多普勒血流显像仪，全部受检者由固定人员进行超声心动图检查，取心尖四腔心切面，检测34例接受经皮冠状动脉内支架植入术的冠心病患者和正常对照组(34例)的二尖瓣口和右上肺静脉血流频谱。冠心病组分别于冠脉内支架植入术术前3天内、术后3天、3个月内进行检查。比较冠心病患者冠脉内支架植入术术前与正常对照组、术后3天、3个月各左室舒张功能指标的检测结果，观察其变化。
结果：1、病例组冠脉内支架植入术前与正常对照组相比较，二尖瓣血流频谱：E峰峰值流速(VE)减低，A峰峰值流速 (VA) 加快(P均<0.05)，E/A比值下降<1(P<0.05)；左室等容舒张时间(IVRT)延长(P<0.05)；肺静脉血流频谱：舒张期峰值流速(Vd)下降(P<0.05)、心房收缩期逆向峰值流速(Va)升高(P <0.05)，收缩期峰值流速(Vs)升高但无统计学意义(P>.05)，Vs/Vd比值增大(P<0.05)。本研究中冠心病组术前有7例病人E/A>，其中4例Va增高>6 cm/s，Vs/Vd.05)。3、病例组术后3个月与术前相比，除Vs(P>0.05)外各指标均有显著改善：VE升高，VA减低 (P均<0.05)，E/A比值下降<1(P<0.05)；IVRT延长；Vd升高、Va下降，Vs/Vd比值增大(P均<0.05)。
结论：1、超声心动图可以正确评价左室舒张功能。2、冠心病所致的心肌缺血坏死等必将导致左室舒张功能障碍。3、经皮冠状动脉内支架植入术后短期内左室舒张功能未出现明显改善。4、随着术后时间的延长，左室舒张功能会得到恢复。
Objective:To evaluate the effects of coronary stent implantation on left ventricular diastolic function in patients with coronary heart disease(CAD) by Doppler echocardiography.
Methods:The mitral intral(MIF) and pulmonary venous flow(PVF) velocities variables in patients who were treated with coronary stent implantation and 34 normal people were recorded by transthoracic Doppler echocardiography.Doppler echocardiography parameters of left ventricular diastolic function in patients with CAD were obtained before coronary stent implantation,during 3 d and 3 months after coronary stent implantation. Comparing doppler parameters of patients before operation with the normal people patients 3 d and 3 months after operation.
Result:1.Compared with normal people,MIF and PVF of patients with CAD varied significantly before coronary stent implantation;There were four patients whose E/A>1,Va>36 cm/s,Vs/Vd Conclusion: 1.Echocardiography is a correct, simple,cost-effective and widely available method to evaluate the effects of coronary stent implantation on left ventricular diastolic function.2.Left ventricular diastolic disfunction exists in patients with CAD.3.No significant change of left ventricular diastolic function was found during the short time after coronary stent implantation. 4.Coronary stent implantation can improve left ventricular diastolic function during 3 months after operation.
引文
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