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目的:结合校正的TIMI记帧计数(CTFC),探讨视频密度阶差(VDS)在评价急性心肌梗死者急诊冠状动脉介入治疗(PCI)前后心肌微灌注中的应用价值。方法:计算120例急性心肌梗死行急诊PCI患者PCI术前后的CTFC和VDS,并统计患者急诊PCI前后的TIMI分级、左室射血分数、住院期间的心脏不良事件。结果:急诊PCI术前后VDS为10.2±3.8、20.8±7.6,术后显著高于术前(P<0.05);PCI后CTFC显著低于术前[(30.3±8.6)∶(22.4±5.6),P<0.05]。急诊PCI后:VDS明显低于冠状动脉造影正常者(P<0.05),CTFC与冠状动脉造影正常者差异无统计学意义(P>0.05)。VDS是住院期间心脏不良事件发生的独立相关因素。VDS≤20者的住院期间心脏不良事件发生显著高于VDS>20者和CTFC≤30者(P<0.05)。结论:VDS评价急性心肌梗死行急诊PCI者的心肌微灌注时较CTFC敏感性更高,可作为急性心肌梗死患者住院期间心脏不良事件发生的一个独立的预测指标。
Objective: To evaluate the value of video density gradient (VDS) in assessing myocardial microperfusion before and after acute coronary intervention (PCI) in patients with acute myocardial infarction (AMI) by combining corrected TIMI frame count (CTFC). Methods: CTFC and VDS were calculated before and after PCI in 120 patients with acute myocardial infarction (PCI). The TIMI grade, left ventricular ejection fraction, and cardiac adverse events during hospitalization were calculated. Results: The VDS before and after emergency PCI was 10.2 ± 3.8 and 20.8 ± 7.6, respectively, which was significantly higher than that before operation (P <0.05). The CTFC after PCI was significantly lower than that before operation [(30.3 ± 8.6) vs (22.4 ± 5.6) , P <0.05]. After emergency PCI, VDS was significantly lower than that of normal coronary angiography (P <0.05). There was no significant difference between CTFC and coronary angiography (P> 0.05). VDS is an independent and relevant factor for the occurrence of cardiac adverse events during hospitalization. Adverse cardiac events during hospitalization with VDS ≤20 were significantly higher than those with VDS> 20 and CTFC ≤30 (P <0.05). Conclusion: VDS is more sensitive to CT perfusion in acute myocardial infarction patients with acute myocardial infarction than CTFC, which can be used as an independent predictor of cardiac adverse events in hospitalized patients with acute myocardial infarction.