经胸超声冠状动脉血流成像预测左前降支狭窄  

Prediction of left anterior descending coronary artery stenosis using transthoracic Doppler echocardiography

作　　者：陈云江[1] 施仲伟[1] 胡厚达[1] 许燕[1] 葛孝虹[1] 

机构地区：[1]上海第二医科大学瑞金医院心脏科,上海200025

出　　处：《中国医学影像技术》2005年第3期430-432,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的　评价经胸超声冠状动脉血流显像技术(TTDE)预测左前降支(LAD)狭窄的准确性。方法　65 名临床怀疑为冠心病的患者,在静息状态下用TTDE探测LAD血流,计算舒张期血流速度与收缩期血流速度的比值(DSVR)。患者在TTDE检查后 24 h内接受冠状动脉造影检查(CAG)。结果　53 例患者的 LAD血流得到探测和测量,其中 14 例有LAD显著狭窄(≥70%,狭窄组),39例无显著狭窄(对照组)。狭窄组LAD的舒张期峰值血流速度和平均血流速度与对照组无显著差异(P>0.05),但收缩期峰值血流速度和平均血流速度均高于对照组(26.4±11.8 cm/s vs 21.1±6.1 cm/s和18.1±7.8 cm/s vs 14.7±4.0 cm/s,P<0.05)。狭窄组的峰值DSVR和平均DSVR较对照组小(分别为 1.4±0.4 比 2.0±0.5和1.4±0.4比1.9±0.4,P<0.0001)。以平均DSVR≤1.6 作为异常时,预测 LAD狭窄的敏感性和特异性分别为85.7%和79.5%。结论　用TTDE测定DSVR是一种简便无创的预测LAD狭窄的新方法。Objective To evaluate the ability of predicting left anterior descending coronary artery (LAD) stenosis by transthoracic Doppler echocardiography (TTDE). Methods Sixty-five patients suspected coronary artery disease were examined by TTDE. LAD flow was explored and the diastolic-to-systolic flow velocity ratio (DSVR) was calculated. All patients underwent coronary artery angiography within 24 hours after the TTDE examination. Results Adequate spectra Doppler recordings of coronary flow in the distal LAD were obtained in 53 patients (81.5%). Fourteen patients had significant LAD stenosis (≥70%, stenosis group) and the remaining 39 were as the control. The peak and mean diastolic LAD flow velocity were not different between the two groups (P>0.05), the peak and mean systolic LAD flow velocity in stenosis group were significantly faster than that in control group (26.4±11.8 cm/s vs 21.1±6.1 cm/s and 18.1±7.8 cm/s vs 14.7±4.0 cm/s, respectively; P<0.05). There was a significant difference in mean and peak DSVR between the two groups (1.4±0.4 vs 1.9±0.4 and 1.4±0.4 vs 2.0±0.5, respectively; P<0.0001). When mean DSVR ≤1.6 was considered to be abnormal, the sensitivity and specificity for detecting significant LAD stenosis were 85.7% and 79.5% respectively. Conclusion TTDE is a noninvasive means for detecting significant LAD stenosis.

关 键 词：超声心动描记术 左前降支 血流速度 冠状动脉疾病 

分 类 号：R543.3[医药卫生—心血管疾病] R445.1[医药卫生—内科学]