药物负荷超声与经胸超声测定冠状动脉储备在冠心病诊断中的价值  

The value of coronary flow reserve assessment from pharmaceutical stress echocardiography for diagnosis of coronary artery disease

作　　者：丁风华[1] 施仲伟[1] 胡厚达[1] 葛孝虹[1] 曹敏[1] 许燕[1] 

机构地区：[1]交通大学医学院附属瑞金医院心内科,上海200025

出　　处：《临床超声医学杂志》2007年第5期276-278,共3页Journal of Clinical Ultrasound in Medicine

摘　　要：目的比较和评价药物负荷超声心动图与经胸多普勒超声测定冠状动脉血流储备(CFR)对冠心病的诊断价值。方法47例疑为冠心病患者于冠状动脉造影(CAG)前进行双嘧达莫药物负荷超声心动图检查,并用经胸多普勒技术测定左前降支(LAD)的CFR。结果根据CAG结果分为LAD显著狭窄组(A组,n=13)和非显著狭窄组(B组,n=34)。显著狭窄组的LAD供血区域室壁运动积分显著增高(P<0.001)而CFR显著降低(P=0.001)。两项技术结合,诊断LAD显著狭窄的敏感性、特异性和准确性分别达到92%、82%和85%。结论双嘧达莫负荷超声心动图结合CFR测定可提高诊断LAD显著狭窄的敏感性。Objective To investigate the value of wall motion analysis and coronary flow reserve （CFR） assessed by pharmaceutical stress echocardiography for diagnosing coronary artery disease （CAD）. Methods 47 patients with suspected CAD underwent dipyridamole stress echocardiography, left ventricular wall motion analysis and CFR assessment in the left anterior descending artery （LAD） were performed one day before coronary angiography （CAG）. Results Patients were divided into 2 groups according to angiographic results. Patients in group A （ n = 13） had a significant stegnostic LAD （ ≥70% ） and in group B （ n = 34） there was no stenosis in the LAD. Compared to group B, the average wall motion score （WMS） was higher （ P 〈 0.001） and CFR in LAD was lower （ P = 0. 001 ） in group A. By combining WMS and CFR assessment, the diagnostic sensitivity, specificity and accuracy were 92%, 82% and 85% respectively. Conclusion Combination of pharmaceutical stress echocardiography and transthoracic echocardiographic assessment of CFR can improve the sensitivity of CAD diagnosis.

关 键 词：药物负荷超声心动图 冠状动脉血流储备 双嘧达莫 左前降支 

分 类 号：R542.2[医药卫生—心血管疾病]