腺苷负荷实时三维超声心动图试验诊断冠心病的临床价值  

The Value of the Adenosine Stress Real-time Three Dimensional Echocardiography in the Diagnosis of Coronary Heart Disease

作　　者：张娟娟[1] 

机构地区：[1]泰安市第四人民医院内科,泰安271000

出　　处：《中国医药导刊》2009年第2期214-215,218,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨腺苷负荷实时三维超声心动图试验(3-D ASE)对冠心病(CHD)诊断的敏感性、特异性。方法:随机抽取临床拟诊CHD患者46例.先行静态超声心动图检查,然后静脉注射腺苷拟造成心肌缺血,分别于给药后3分钟、6分钟、11分钟重复上述操作,观察ST段变化,监测血压和心率.记录患者症状和不良反应.存储图像。出现节段室壁运动异常为阳性。试验后2周内行冠状动脉造影(SCA)。计算3-D ASE的敏感性、特异性。结果:以SCA为金标准.该试验方法诊断CHD的敏感性为75.86%、特异性为88.23%。3-D ASE对单支、双支、三支冠状动脉病变患者检出的敏感性分别为60.0%(9/15)、88.9%(8/9)、100%(5/5例)。结论:3.D ASE可用于CHD的诊断.敏感性及特异性均较高。Objective： To estimate the sensitivity and specificity in diagnosis of Coronary Artery Disease using the adenosine stress realtime three dimensional echocardiography（RT3-DE）. Methods： 40 cases were randorrdy sampled from those with suspected coronary artery disease. After completing echocardiography examination, the adenosine was injected intravenously. The echocardiography process mentioned above was repeated in 3 minutes and 6 minutes from the injection,and 5 minutes after the injection respectively. Monitoring the changes of the ST segments, heart rate and blood pressure were achieved, and the symptoms and untoward effects as well as the imaging were recorded through the test, Abnormal wall motion was positive result. All the patients included in this test received the coronary angiography within two weeks subsequently. Results of the three dimensional eehocardiography were counted its sensitivity and specificity. Results： Compared to coronary angiography, the sensitivity and the specificity in the diagnosis of coronary artery disease were 75.86% and 88.23% respectively. The sensitivity for patients with one,two,three coronary artery disease by 3-DE were 60%（9/15 ） ,88.9% （8/9） ,100% （5/5） respectively. Conclusions： The adenosine stress three dimensional eehocardiography is feasible in diagnosis of coronary artery disease, has high sensitivity and specificity.

关 键 词：腺苷 实时三维超声心动图 冠状动脉造影 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病]