目的：探讨实时三维超声(RT-3DE)技术在评价冠心病患者经皮冠状动脉介入术(PCI)前后局部室壁运动中的临床意义。方法选取临床诊断冠心病及可疑冠心病拟行冠状动脉造影示前降支为“罪犯血管”的患者为冠心病组(30例),对照组为30例正常人。应用RT-3DE测量左室心肌局部容积曲线和局部射血分数(rEF),比较两组的9个节段的rEF及冠心病患者接受PCI手术前、术后3天、术后1个月、术后6个月的局部射血分数。结果与对照组相比,冠心病组PCI术前缺血区域相应节段的rEF明显降低(P<0．05)。与PCI术前相比,冠心病组患者术后1个月开始部分节段rEF增大(P<0．05),6个月增加最明显(P<0．05),术后3天rEF无明显变化。结论 RT-3DE可准确识别缺血心肌节段,动态观察PCI术前、术后局部心肌功能的变化,判断术后疗效。%Objective To investigate the application of real-time three-dimensional echocardiography (RT-3DE) to estimate myocar-dial regional wall motion in coronary artery disease before and after percutaneous coronary intervention( PCI) . Methods The study consisted of 30 normal subjects and 30 patients with coronary artery disease. Patients included in the study were those with left anterior descending coro-nary artery( LAD) to be “criminal vessel”. Three dimensional image data were acquired and regional volume curves and regional ejection fractions ( rEF) in control and patient group ( before PCI surgery, three days, one month and six months after surgery) were derived. Region-al ejection fractions at each follow-up period in the patient group were measured. Results Before PCI surgery, the rEFs of ischemic myocar-dium were obviously lower than those in the normal group (P<0. 05). The rEFs increased gradually in most segments on one and six months after PCI surgery. Conclusion RT-3DE can accurately differentiate abnormal perfusion segments from normal ones.
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