中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2012年
3期
48-51
,共4页
组织多普勒%二维超声心动图%腺苷%超声心动图负荷试验%冠状动脉造影
組織多普勒%二維超聲心動圖%腺苷%超聲心動圖負荷試驗%冠狀動脈造影
조직다보륵%이유초성심동도%선감%초성심동도부하시험%관상동맥조영
Tissue doppler imaging%Two-dimensional echocardiography%Adenosine%Stress echocardiography%Coronary angiography
目的 以冠状动脉造影为金标准,评价组织多普勒腺苷负荷超声心动图试验定量诊断冠心病的敏感性、特异性.方法 采用脉冲组织多普勒超声心动图技术,对48例临床拟诊冠心病(CAD)的患者,静脉注射腺苷拟造成心肌缺血,注射剂量为140μg/(kg·min),用药时间6 min(总剂量0.8 mg/kg),测量左室16节段的收缩期室壁运动最大速度和加速度及各节段心肌收缩的达峰时间.同时应用二维(2D)超声心动图目测各节段心肌负荷前后的运动异常.结果 30例确诊为CAD的患者中组织多普勒腺苷负荷试验阳性24例.18例冠状动脉造影正常的患者中有3例为组织多普勒腺苷负荷试验阳性.应用组织多普勒腺苷超声心动图诊断CAD的敏感性为80％( 24/30),特异性为83.3％ (15/18),阳性预测值为88.9％ (24/27),阴性预测值为71.4％( 15/21),诊断单支、双支和三支病变的敏感性分别为66.7％、75.0％和100％.而30例确诊为CAD的患者中2D超声心动图腺苷负荷试验阳性22例.18例冠状动脉造影正常的患者中有5例为2D超声心动图腺苷负荷试验阳性.2D腺苷超声心动图负荷试验诊断CAD的敏感性为73.3％ (22/30),特异性为72.2％ (13/18),试验阳性预测值为81.5％ (22/27),阴性预测值为61.9％( 13/21),诊断单支、双支和三支病变的敏感性分别为55.6％、66.7％、100％.结论 组织多普勒腺苷负荷超声心动图试验可安全用于冠心病的诊断,其敏感性及特异性高,不良反应轻微,较二维超声心动图试验更加客观准确,可作为冠状动脉造影前的初筛.
目的 以冠狀動脈造影為金標準,評價組織多普勒腺苷負荷超聲心動圖試驗定量診斷冠心病的敏感性、特異性.方法 採用脈遲組織多普勒超聲心動圖技術,對48例臨床擬診冠心病(CAD)的患者,靜脈註射腺苷擬造成心肌缺血,註射劑量為140μg/(kg·min),用藥時間6 min(總劑量0.8 mg/kg),測量左室16節段的收縮期室壁運動最大速度和加速度及各節段心肌收縮的達峰時間.同時應用二維(2D)超聲心動圖目測各節段心肌負荷前後的運動異常.結果 30例確診為CAD的患者中組織多普勒腺苷負荷試驗暘性24例.18例冠狀動脈造影正常的患者中有3例為組織多普勒腺苷負荷試驗暘性.應用組織多普勒腺苷超聲心動圖診斷CAD的敏感性為80％( 24/30),特異性為83.3％ (15/18),暘性預測值為88.9％ (24/27),陰性預測值為71.4％( 15/21),診斷單支、雙支和三支病變的敏感性分彆為66.7％、75.0％和100％.而30例確診為CAD的患者中2D超聲心動圖腺苷負荷試驗暘性22例.18例冠狀動脈造影正常的患者中有5例為2D超聲心動圖腺苷負荷試驗暘性.2D腺苷超聲心動圖負荷試驗診斷CAD的敏感性為73.3％ (22/30),特異性為72.2％ (13/18),試驗暘性預測值為81.5％ (22/27),陰性預測值為61.9％( 13/21),診斷單支、雙支和三支病變的敏感性分彆為55.6％、66.7％、100％.結論 組織多普勒腺苷負荷超聲心動圖試驗可安全用于冠心病的診斷,其敏感性及特異性高,不良反應輕微,較二維超聲心動圖試驗更加客觀準確,可作為冠狀動脈造影前的初篩.
목적 이관상동맥조영위금표준,평개조직다보륵선감부하초성심동도시험정량진단관심병적민감성、특이성.방법 채용맥충조직다보륵초성심동도기술,대48례림상의진관심병(CAD)적환자,정맥주사선감의조성심기결혈,주사제량위140μg/(kg·min),용약시간6 min(총제량0.8 mg/kg),측량좌실16절단적수축기실벽운동최대속도화가속도급각절단심기수축적체봉시간.동시응용이유(2D)초성심동도목측각절단심기부하전후적운동이상.결과 30례학진위CAD적환자중조직다보륵선감부하시험양성24례.18례관상동맥조영정상적환자중유3례위조직다보륵선감부하시험양성.응용조직다보륵선감초성심동도진단CAD적민감성위80％( 24/30),특이성위83.3％ (15/18),양성예측치위88.9％ (24/27),음성예측치위71.4％( 15/21),진단단지、쌍지화삼지병변적민감성분별위66.7％、75.0％화100％.이30례학진위CAD적환자중2D초성심동도선감부하시험양성22례.18례관상동맥조영정상적환자중유5례위2D초성심동도선감부하시험양성.2D선감초성심동도부하시험진단CAD적민감성위73.3％ (22/30),특이성위72.2％ (13/18),시험양성예측치위81.5％ (22/27),음성예측치위61.9％( 13/21),진단단지、쌍지화삼지병변적민감성분별위55.6％、66.7％、100％.결론 조직다보륵선감부하초성심동도시험가안전용우관심병적진단,기민감성급특이성고,불량반응경미,교이유초성심동도시험경가객관준학,가작위관상동맥조영전적초사.
Objective To study the value of tissue doppler imaging by adenosine stress echocardiography in diagnosis of coronary artery disease and determine the sensitivity and specificity by the golden criterion of coronary angiography.Methods Tissue doppler imaging adenosine stress echocardiography was performed in 48 suspected patients with coronary artery disease using continuous infusion dose of 140 μg/( kg.min) in 6 mins ( total dose of 0.8 μg/kg).Maximal systolic left ventricular wall segments motion velocities,accelerations and peak time were measured.Meanwhile,two-dimensional echocardiograph was used to estimate the extent of ventricular wall segments motion abnormalities before and after stresses subjectively Results Tissue doppler imaging adenosine stress echocardiography was positive in 24 cases out of 30 patients with coronary artery disease and 3 cases out of 18 normal persons.The sensitivity of this test was 80.0％ ( 24/30),the specificity was 83.3％ ( 15/18),the positive predicative value was 88.9％ ( 24/27 ) and the negative predicative value was 71.4％ ( 15/21 ).The sensitivity of diagnosis of coronary artery disease with one,two and three-vessel stenosis were 66.7％,75.O％ and 100％,respectively.Two-dimensional stress echocardiography was positive in 22 cases out of 30 patients with coronary artery disease and 5 cases out of 18 normal persons.The sensiiivity of this test was 73.3％( 22/30),the specificity was 72.2％ (13/18),the positive predicative value was 81.5％ (22/27) and negative predicative value was 61.9％ (13/21).The sensitivity in diagnosis of coronary artery disease with one,two and three-vessel stenosis were 55.6％,66.7％ and 100％,respectively.Conclusions Tissue doppler imaging adenosine stress echocardiography can be safely performed in suspected CAD patients,with high sensitivity and specificity.Moreover,the side effects in diagnosis of coronary artery disease are minimal.It is more objective and accurate than 2-Dechocardiography and can be used to screen patients with coronary artery disease.
