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目的 研究冠状动脉阻抗参数对微栓塞后冠状动脉微循环功能的评价。方法 10头小型猪不开胸经导管重复性注入前降支微栓塞球 (45 μm) ,通过多普勒导丝、压力导丝和腔内超声导管与心电同步分别在微栓塞前及不同微栓塞程度采集前降支中段基础状态和最大充血状态的多普勒信号、压力信号以及腔内超声图像 ,通过自制软件建立了反映冠脉脉动流阻抗的冠脉阻抗参数。结果 因子分析发现一次谐波基础冠脉阻抗和一次谐波最小冠脉阻抗分别与基础状态和最大充血状态冠脉阻抗参数中提取出的第一主成分相关性最好 (r分别为 0 913和 0 95 0 )。最小冠脉阻抗在少量微栓塞 (5万个 )无明显变化 ,随着微球量的增加逐渐增加 ,自 10万个微球开始最小冠脉阻抗较微栓塞前 (2 6 7mmHg·ml-1·s-1± 10 6mmHg·ml-1·s-1)均明显增加 (P <0 0 5 ) ,10万到 15万个微球时最小冠脉阻抗无明显变化。一次谐波最小冠脉阻抗在少量微栓塞球 (5万个 )时无明显变化 ,随着微栓塞球量的增加逐渐增加 ,自 14万个微球开始一次谐波最小冠脉阻抗较微栓塞前明显增加 (P <0 0 5 )。结论 一次谐波冠脉阻抗比平均冠脉阻抗更能代表不同微栓塞程度时冠脉阻抗参数的变化 ,微血管功能障碍程度与微栓塞程度不成正比。
Objective To study the coronary artery impedance parameters on the evaluation of microcirculation function of coronary artery after microembolization. Methods Ten miniature pigs were injected into the anterior descending coronary artery (45 μm) repeatedly without catheterization through the catheter. The doppler wire, pressure guide wire and intracavitary ultrasound catheter were synchronized with ECG before and after micro-embolization The degree of micro-embolization was used to acquire the Doppler signal, pressure signal and intraluminal ultrasound images of the basal and anterior segment of the anterior descending artery. The coronary impedance parameters reflecting the coronary flow impedance were established by homemade software. Results The factor analysis showed that the correlation between the first principal component of the fundamental harmonic impedance of the first harmonic and the minimum impedance of the first harmonic and the coronary impedance parameter of the maximal congestive state were the best (r = 0 913 and 0 95 0). The minimal coronary artery impedance had no significant change in a small amount of micro-embolism (50,000), and gradually increased with the increase of the amount of microspheres. The minimum coronary impedance was slightly lower than that before micro-embolization (267mmHg · ml-1 · S-1 ± 10 6mmHg · ml-1 · s-1) were significantly increased (P <0.05). There was no significant change in minimum coronary impedance between 100,000 and 150,000 microspheres. The first harmonic minimal coronary impedance had no significant change in a small amount of micro-embolism balls (50,000), and gradually increased with the increase of the amount of micro-embolism balls. The first harmonic minimum coronary impedance was slightly embolized from 140,000 microspheres Before significantly increased (P <0 05). Conclusions The first harmonic impedance is more representative of the changes of coronary impedance parameters than the mean coronary impedance. The degree of microvascular dysfunction is not proportional to the degree of micro-embolism.