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目的探讨实时三维超声心动图(RT-3DE)对经皮冠状动脉介入术(PCI)后患者支架内再狭窄(ISR)的诊断价值。方法对100例接受PCI治疗的单纯左前降支受累患者,于PCI术前3d及术后半年行RT-3DE检查,获得左室前壁及前室间隔基底段、中间段、心尖段PCI术前、后平均舒张末期容积比(rEDV′%)、平均收缩末期容积比(rESV′%)、不同步节段数比(DS%)。以冠脉CT检查(CTA)为金标准,分析rEDV′%、rESV′%及DS%诊断ISR的准确度。结果 (1)ISR组患者PCI术前、后rEDV′%、rESV′%差异无统计学意义(P>0.05);正常组患者PCI术前、后rEDV′%、rESV′%差异有统计学意义(P<0.05)。(2)ISR组与正常组rEDV′%、rESV′%、DS%比较,差异有统计学意义(P<0.05)。(3)ROC曲线显示:rEDV′%、rESV′%、DS%3项参数对ISR的诊断价值比较大。结论 RT-3DE通过测量计算的rEDV′%、rESV′%,是评估PCI术后ISR的有效指标。
Objective To investigate the value of real-time three-dimensional echocardiography (RT-3DE) in the diagnosis of in-stent restenosis (ISR) after percutaneous coronary intervention (PCI). Methods One hundred cases of patients with simple left anterior descending coronary artery who underwent PCI were examined by RT-3DE three days before PCI and six months after operation. The basal and anterior segments of the left ventricular anterior wall and the anterior septum were obtained. , Post-average end-diastolic volume ratio (rEDV ’%), mean end-systolic volume ratio (rESV’%), and unsynchronized segment ratio (DS%). Using coronary CT examination (CTA) as the gold standard, the accuracy of rEDV ’%, rESV’% and DS% in diagnosing ISR was analyzed. Results (1) The rEDV ’%, rESV’% of patients in ISR group had no significant difference before and after PCI (P> 0.05). The difference of rEDV ’%, rESV’% before and after PCI in normal group was statistically significant (P <0.05). (2) Compared with rEDV ’%, rESV’%, DS% of ISR group and normal group, the difference was statistically significant (P <0.05). (3) The ROC curve shows that the three parameters of rEDV ’%, rESV’% and DS% are of great value in the diagnosis of ISR. Conclusions The rEDV ’% and rESV’% calculated by RT-3DE are effective indicators for evaluating ISR after PCI.