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目的 :探讨心磁图法在冠心病 (CHD)的诊断及支架置入术后随访中的临床应用价值。方法 :12 7例CHD患者 (冠状动脉造影至少有 1支血管狭窄≥ 70 % )在冠状动脉造影术前接受心磁图检查 ,并随访其中 5 7例行支架置入术的CHD患者 ,术后 72h以及 1个月时分别进行心磁图检查 ;116例健康人作为对照组 ,分析两个定量指标 :①复合心室激动指数 (CVEI) :分为异常值域 (- 10 0～ 0 )及正常值域 (1～ 10 0 ) ;②M值 :心室复极期所有电流密度图的平均分级。结果 :CHD组的CVEI[(- 5 1.0 1± 4 6 .79) % ]和M值 (3.0 1± 0 .6 0 )显著高于对照组 [CVEI:(2 4 .2 3± 5 1.4 2 ) % ;M值 :2 .5 0± 0 .4 7,P <0 .0 1]。 5 7例行支架术后 72h的CVEI(- 4 3.95± 4 9.82 )、M值 (2 .99±0 .6 0 )与术前相比 [CVEI:(- 4 6 .77± 5 1.6 2 ) % ;M值 :3.0 0± 0 .5 8]无统计学意义 (P >0 .0 5 ) ;术后 1个月时CVEI[(- 2 1.2 1± 6 0 .95 ) % ]、M值 (2 .77± 0 .6 0 )较术前有显著改善 (P <0 .0 1)。结论 :心磁图对CHD患者具有较高的诊断价值 ,是冠状动脉支架置入术后随访的一项很有前途的无创性检查方法
Objective: To investigate the clinical value of magnetic resonance imaging in the diagnosis of coronary heart disease (CHD) and follow-up after stent implantation. Methods: Twenty-seven CHD patients (at least 1 vessel stenosis≥70%) underwent coronary angiography before coronary angiography. Fifty-seven patients with CHD were followed up for stent implantation. After operation 72h, and 1 month respectively; 116 healthy subjects served as the control group. Two quantitative indexes were analyzed: (1) The composite ventricular activation index (CVEI) was divided into abnormal range (-10 ~ 0) and normal Value range (1 ~ 10 0); ② M value: average grading of all current density plots during ventricular repolarization. Results: CVEI [(- 5 1.0 1 ± 46.79%)] and M (3.0 1 ± 0.60) in the CHD group were significantly higher than those in the control group [CVEI: (24.3 ± 5 1.4 2 )%; M value: 2.50 ± 0.47, P <0.01]. The CVEI (- 4. 3.95 ± 4.982) and M (2.99 ± 0.60) at 72 h postoperatively in 5 7 patients were significantly lower than those before operation [CVEI: (-4.677 ± 5 1.6 2) %; M value: 3.0 0 ± 0.58] was not statistically significant (P> 0.05); at 1 month after operation, CVEI [(- 2 1.2 1 ± 60.95)%], M value (2 .77 ± 0. 60) than the preoperative significantly improved (P <0. 01). Conclusions: Magnetoencephalography has a high diagnostic value in patients with CHD and is a promising noninvasive method for follow-up of coronary stent implantation