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[经皮冠状动脉腔内血管成形术期间冠状动脉静脉血氧饱和度的连续监测及其与心电图ST段改变的关系]

[Continuous monitoring of coronary venous oxygen saturation during PTCA and its relation to electrocardiographic ST changes].

作者信息

Mikami M, Mikuniya A, Fujino Y, Higashiyama A, Takahashi M, Sato M, Sasaki M, Fukushi T, Onodera K, Oike Y

机构信息

Second Department of Internal Medicine, Hirosaki University School of Medicine.

出版信息

J Cardiol. 1992;22(1):43-50.

PMID:1307577
Abstract

The purpose of this study was to investigate change in coronary venous oxygen saturation (CSO2-Sat) during percutaneous transluminal coronary angioplasty (PTCA) and to compare the results with those of standard 12-lead ECGs (s-ECG) and epicardial ECG induced using an intracoronary guidewire (ic-ECG). CSO2-Sat was measured continuously in 10 patients undergoing PTCA; 5 patients with lesions in the left anterior descending coronary artery (LAD), one with lesions in the left circumflex artery (LCX), and 4 with right coronary artery (RCA) lesions. The results were as follows: 1. In all 6 patients with stenotic lesions in the left coronary artery, CSO2-Sat decreased by 5 to 22% immediately after balloon inflation. Significant changes in ic-ECG (ST deviation > or = 0.1 mV) were observed in 5 of the 6 patients, while significant changes in s-ECG (ST deviation > or = 0.1 mV) were observed in only 3 of the 6 patients. The s-ECG did not seem to be sensitive enough to represent myocardial ischemia in the LCX. 2. The interval from the balloon inflation to the significant change was shorter for CSO2-Sat than for the ECGs in 4 of the 5 patients with LAD lesions, except Case 4. The recovery time of CSO2-Sat to the basal level on balloon deflation was longer than the recovery times of ic-ECG and s-ECG. 3. There was no significant change in the CSO2-Sat in 3 of the 4 patients undergoing PTCA for RCA lesions, while significant changes were observed in the ic-ECG and s-ECG in all 4 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本研究的目的是调查经皮腔内冠状动脉成形术(PTCA)期间冠状静脉血氧饱和度(CSO2-Sat)的变化,并将结果与标准12导联心电图(s-ECG)以及使用冠状动脉内导丝诱发的心外膜心电图(ic-ECG)的结果进行比较。对10例行PTCA的患者连续测量CSO2-Sat;5例患者左前降支冠状动脉(LAD)有病变,1例患者左旋支动脉(LCX)有病变,4例患者右冠状动脉(RCA)有病变。结果如下:1. 在所有6例左冠状动脉狭窄病变患者中,球囊扩张后立即CSO2-Sat下降了5%至22%。6例患者中有5例观察到ic-ECG有显著变化(ST段偏移≥0.1 mV),而6例患者中只有3例观察到s-ECG有显著变化(ST段偏移≥0.1 mV)。s-ECG似乎对代表LCX中的心肌缺血不够敏感。2. 除病例4外,5例LAD病变患者中有4例,CSO2-Sat从球囊扩张到显著变化的间隔时间比心电图短。球囊放气后CSO2-Sat恢复到基础水平的时间比ic-ECG和s-ECG的恢复时间长。3. 4例接受RCA病变PTCA的患者中有3例CSO2-Sat无显著变化,而所有4例患者的ic-ECG和s-ECG均有显著变化。(摘要截断于250字)

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