CAJ | 학술논문

目的探讨心肌灌注造影(MCE)技术在大剂量多巴酚丁胺负荷前后早期诊断冠心病的价值.方法对临床疑为冠心病患者38例,进行大剂量多巴酚丁胺负荷超声心动图试验,分别在静息状态和多巴酚丁胺负荷超声心动图试验终止时即刻行MCE检查.以冠状动脉造影为金标准将大剂量多巴酚丁胺负荷超声心动图前后心肌灌注状态目测法对冠心病的检出率进行比较.结果多巴酚丁胺负荷超声心动图检查的38例患者中,9例(24%,9/38)达到峰值负荷水平,22例(58%,22/38)达到中级负荷水平.其中通过冠状动脉造影诊断的27例冠心病患者在多巴酚丁胺负荷前后,通过心肌灌注状态目测法诊断心肌缺血患者的例数分别为10例(37%,10/27)及24例(89%,24/27,χ2=15.565,P＜0.01).结论大剂量多巴酚丁胺负荷超声心动图结合MCE可提高缺血心肌的检出率,发现隐匿性心肌缺血,为临床无创性诊断早期冠心病患者提供新方法.
목적탐토심기관주조영(MCE)기술재대제량다파분정알부하전후조기진단관심병적개치.방법 대림상의위관심병환자38례,진행대제량다파분정알부하초성심동도시험,분별재정식상태화다파분정알부하초성심동도시험종지시즉각행MCE검사.이관상동맥조영위금표준장대제량다파분정알부하초성심동도전후심기관주상태목측법대관심병적검출솔진행비교.결과 다파분정알부하초성심동도검사적38례환자중,9례(24%,9/38)체도봉치부하수평,22례(58%,22/38)체도중급부하수평.기중통과관상동맥조영진단적27례관심병환자재다파분정알부하전후,통과심기관주상태목측법진단심기결혈환자적례수분별위10례(37%,10/27)급24례(89%,24/27,χ2=15.565,P＜0.01).결론 대제량다파분정알부하초성심동도결합MCE가제고결혈심기적검출솔,발현은닉성심기결혈,위림상무창성진단조기관심병환자제공신방법.
Objective To investigate the value of myocardial contrast echocardiography(MCE)combined with high-dose dobutamine stress echocardiography(DSE)in the early diagnosis of coronary artery disease(CAD).Methods The dobutamine stress MCE and SonoVue contrast infusion were performed before an elective percutaneous coronary intervention in 38 patients with suspected CAD.The total and regional perfusion were scored as normal or abnormal and attributed to the three main epicardial coronary arteries using a 16-segment left ventricular model.Results An intermediate stress level was obtained in 22(58%)patients,and 9(24%)patients were obtained with peak stress.Twenty seven of 38 patients were diagnosed as CAD by quantitative coronary angiography.A perfusion defect was detected in 89% of the patients at peak stress,compared to 37% at baseline,there was significant difference(χ2=15.565,P<0.01).ConclusionsThe MCE combined with DSE can increase the sensitivity of myocardial ischemia detection.As a new non-invasive method,MCE combined with DSE could be used in the early diagnosis of CAD.