多巴酚丁胺负荷超声心动图结合组织多普勒成像诊断冠心病  

Clinical application of dobutamine stress echocardiography and tissue Doppler imaging in the diagnosis of coronary artery disease

作　　者：冯莉莉[1] 葛郁芝[2] 叶雪存[1] 盛国太[3] 曹平良[4] 刘健萍[4] 刘东生[2] 吴志婷[2] 

机构地区：[1]江西省人民医院超声科,南昌330006 [2]江西省心血管病研究所 [3]江西省人民医院心内科 [4]江西省人民医院干部保健科

出　　处：《中华医学超声杂志（电子版）》2005年第6期340-342,共3页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：江西省卫生厅资助课题(编号0301103)

摘　　要：目的探讨多巴酚丁胺负荷超声心动图(DSE)结合组织多普勒成像(TDI)在冠心病(CHD)诊断中的应用价值。方法选择胸闷或胸痛怀疑CHD的患者50例,应用TDI测量静息状态下以及多巴酚丁胺峰值负荷状态下左心室前壁中段收缩峰值速度(Vs),所有入选对象均进行冠状动脉造影,并根据左前降支狭窄程度是否≥50%分为左前降支狭窄组(LST组,17例)与左前降支非狭窄组(non-LST组,20例)。结果左心室前壁中段Vs在静息状态下LST与non-LST组比较差异无统计学意义(P＞0.05),在多巴酚丁胺峰值负荷状态下差异有非常显著性(P＜0.01),且Vs增加幅度2组相比差异也有非常显著性(P＜0.01)。结论DSE结合TDI是诊断CHD有价值的定量分析方法,DSE在诊断CHD时的敏感性、准确性明显优于静息状态超声心动图。Objective To assess the value of dobutamine stress echocardiography （DSE） and tissue Doppler imaging （TDI） in the diagnosis of coronary heart disease （CHD）. Methods The maximum of myocardial systolic velocity （Vs） of mid-anterior wall of left ventricle was detected by TDI at rest status （Rest） and at peak dobutamine stress status （Peak） in 40 patients with suspected CHD. All patients underwent coronary arteriography and were divided into 2 groups, ie, left anterior descending branch stenosis （LST） group and non-LST group, according to the results whether the anterior descending branch of left coronary artery was stenotic （ ≥50% ） or not. Results There was significantly difference in the Vs of mid-anterior wall at peak dobutamine stress status between LST group and non-LST group （ P 〈 0. 01 ） ; while there was no significant difference in the Vs of mid-anterior wall at rest status between LST group and non-LST group （P 〉 0. 05 ）. Conclusions The sensitivity and accuracy of diagnosing CHD by DSE is superior to those of echocardiography at rest. In addition, the combination of DSE with DTI is helpful for diagnosis of CHD.

关 键 词：压力超声心动图描记术 冠状动脉疾病 多巴酚丁胺 超声心动图 组织多普勒成像 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病]