冠心脏病室壁运动异常的超声心动图临床研究  

The Analysis of Coronary Atherosclerotic Heart Diseases about Left Ventricle Regional Wall Motion Abnormalities

作　　者：闵敏 程开诚 张新霞 胡雪松 

机构地区：[1]广东省深圳市福田医院心内科,508055

出　　处：《实用心脑肺血管病杂志》2011年第10期1648-1649,共2页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的通过超声心动图（ultrasonic cardiography,UCG）观察冠心病患者室壁节段性运动情况,探讨冠脉病变与室壁运动异常检出率的关系,从而判断UCG诊断冠心病的临床价值。方法回顾性分析200例冠心病患者,全部病例均行冠脉造影（CAG）检查提示血管病变。UCG利用左室16节段法通过多切面检测各室壁节段性运动异常并对其进行评价。结果 200例冠心病患者中CAG显示狭窄≥90%的血管对应节段性室壁运动异常检出率为61.42%;血管狭窄介于50%~90%的患者室壁运动异常检出率5.05%。UCG对冠脉病变的检测灵敏度受病变部位及范围影响。多支病变检出灵敏度较高,单支病变中前降支检出灵敏度最高。陈旧性心肌梗死组室壁运动异常检出灵敏度最高,稳定性心绞痛组检出率最低。结论 UCG对诊断冠心病有重要临床价值。但对狭窄程度较轻或范围小的冠脉病变假阴性率高,在临床工作中需综合判断。Objective To observe regional wall motion abnormality of patients with coronary heart disease by ultrasonic cardiography and explore the correlation between coronary artery disease and wall motion abnormality detection rate,evaluate the value of ultrasonic cardiography.Methods 200 Patients with coronary heart disease were retrospectively analyzed;All cases were shown Single or multi-vessel disease by coronary arteriography.Standard short and long axis image of left ventricle were measured by using ultrasonic cardiography and it was displayed regional wall motion abnormality.Results The segmental wall motion abnormality detection rate is 61.42% in patients whose coronary angiography showed ≥ 90% stenosis,it is 5.05% in patients whose coronary artery stenosis was between 50% to 90%.The coronary artery disease detection sensitivity of color doppler echocardiography is increased with the involved range of disease.The multi-vessel disease is highest and the anterior descending branch is highest in single-vessel diseases.The segmental wall motion abnormality detection rate of different types of coronary heart diseases is not the same.The old myocardial infarction group′s detection rate is highest and the stable angina group is the lowest.Conclusion Ultrasonic cardiography is a noninvasive,convenient,and cheaper method to coronary lesions,the false negation rate is high.The comprehensive judgement in the clinical work is needed.

关 键 词：超声心动图 冠状动脉造影 节段性室壁运动异常 心肌梗死 

分 类 号：R743.3[医药卫生—神经病学与精神病学]