腺苷超声心动图负荷试验对老年冠心病患者的诊断价值  

Value of adenosine stress echocardiography in diagnosis of coronary artery disease in elderly person

作　　者：陈欣[1] 杨明[1] 韩凌[1] 邹凤军[1] 丁五麟[1] 高亢[1] 胡文泽[1] 

机构地区：[1]首都医科大学附属复兴医院心血管内科,北京100038

出　　处：《临床内科杂志》2011年第11期749-751,共3页Journal of Clinical Internal Medicine

摘　　要：目的评价腺苷超声心动图负荷试验（ASE）对于老年患者诊断冠心病的敏感性、特异性和安全性。方法收集临床拟诊冠心病的老年患者64例，静脉注射腺苷每分钟140μg/kg，总计时6分钟，总剂量0．8mg／kg，并同时记录室壁运动、患者症状和不良反应等。左心室16节段中出现室壁运动异常为阳性。于试验后1周内行冠状动脉造影，并以其为金标准，计算腺苷超声心动图负荷试验敏感性和特异性等。结果腺苷超声心动图负荷试验诊断冠心病的敏感性为68．8％，特异性为81．2％，准确性为75％。诊断冠心病单支、双支和三支病变的敏感性分别为60．6％、70．0％和83．3％。腺苷超声心动图负荷试验不良反应发生率为62．0％，但症状轻微。结论腺苷超声心动图负荷试验对于老年人是一种较理想的诊断冠心病的无创检查方法。Objective To assess the value of adenosine stress echocardiography （ASE） in diagnosis of CAD in eider person. Methods 140 μg/（kg · min） of Adenosine was infusion in 64 elder suspect CAD patients within 6min, the left ventricular walt motion was detected by echocardiography during the procedure, and the discomfort of the patients was recorded. Positive criterion was defined as the appearance of wall motion abnormality （WMA）. Then 64 patients underwent coronary angiography in one week,which as the criterion standard for diagnose of CAD. Results The total sensitivity of ASE was 68.8% ,the specificity was 81.2% and the accuracy as 75%. Furthermore the sensitivity of ASE for detection of one,two or three-vessel disease was 60.6% ,70.0% and 83.3% respectively. Side effects due to adenosine were always minimal and well tolerated by the elder patients. Conclusion ASE can be safely performed in suspect elder CAD patients with high sensitivity and specificity.

关 键 词：腺苷 超声心动图负荷试验 室壁运动异常 冠心病 老年 

分 类 号：R541.4[医药卫生—心血管疾病]