目的：探讨食道调搏心负荷二维超声心动图试验(TEAPL-2DE)对冠心病(CHD)介入性治疗效果的评价及介入治疗后检出再狭窄的价值。

方法：1995年4月～1998年9月，38例在我院住院的CHD患者，同期行TEAPL-2DE及冠状动脉造影(CAG)检查，并在1周后均接受冠状动脉介入性治疗［经皮冠状动脉腔内成形术(PTCA)或PTCA+冠状动脉内支架置入—Stent］。在介入性治疗后1、3、6、12个月行TEAPL-2DE追踪检查，并分别与介入治疗前行对比分析，从而评价介入性治疗的效果。介入性治疗疗效判定标准为：①缺血消失：介入性治疗后TEAPL-2DE显示治疗前局限性室壁运动(RWMA)异常部位呈现正常。②缺血改善：介入治疗前RWMA异常部位、范围及程度于治疗后缩小。③缺血无变化：介入治疗前、后RWMA异常部位、范围及程度无变化。④再缺血：介入治疗后随访中曾经缺血消失或改善的心肌又恶化，其程度可以较治疗前轻或重。

结果：38例患者中行TEAPL-2DE检查所示RWMA异常部位，CAG均显著为与该部位血供相关的冠状动脉发生狭窄。提示TEAPL-2DE与CAG检出冠状动脉的符合率相似。TEAPL-2DE观察到CHD介入治疗后3个月疗效最好，3～6个月时介入性治疗发生再狭窄率最高。

结论：PTCA或PTCA+Stent是CHD介入性治疗中疗效确切、成功率高的方法。TEAPL-2DE是显示局部心肌灌注的定性与半定量较好的方法，从而可作为介入性治疗后短期和长期疗效评价的可靠、无创伤性及廉价的一种较好方法。为CHD介入性治疗选择合适的病例及合适的血管提供帮助。

The Value of Two-Dimensional Echocardiography Under Transesophageal Atria Pacing Load in Picking Out Restenosis after Coronary Interventional Therapy (Abstract)

Department of Cardiovascular Disease, The First Affiliated Hospital,

Xinxiang Medical College, Weihui (453100), He′nan

Zhang Yongchun, Liu Jian′en, Huang Luli.

Objective: To assess the value of two-dimenswional echocardiography under transesophageal atrial pacing load test (TEAPL-2DE) in estimating the restenosis after coronary interventional therapy.

Methods: From April. 1995 to Sept. 1998, 38 cases with coronary heart disease (CHD) in the hospital received the TEAPL-2DE test and coronary angiography (CAG), and then had coronary interventional therapy percutaneous transluminal coronary angioplasty (PTCA) or PTCA+Stent implantation. The efficacy was assessed by TEAPL-2DE at the end of 1, 3, 6 and 12 months respectively.

Results: In comparison with CAG, the coincidence rate of coronary stenosis tested by TEAPL-2DE was similar. The best curative effect was achieved 3 months later after the interventional therapy. The restenosis rate was the highest between 3～6 months.

Conclusion: PTCA or PTCA+Stent implantation is a method of interventional therapy for treating CHD with best curative effect and high successful rate. TEAPL-2DE can be used to evaluate the short and long term effectiveness of interventional therapy. It is reliable, non-invasive, and helpful in choosing suitable cases and blood vessels for intowentional therapy with low cost.