腺苷负荷超声心动图结合斑点追踪成像技术检测兔缺血心肌的研究  

Diagnosis of myocardial ischemia by two-dimensional speckle tracking echocardiography during adenosine stress echocardiograph

作　　者：钟慧颖[1] 李金国[1] 钟玲[1] 

机构地区：[1]福建医科大学附属协和医院心脏彩超室,福建福州350001

出　　处：《中国医药导报》2013年第2期15-17,共3页China Medical Herald

基　　金：福建省卫生厅青年科研课题(项目编号:2009-2-26)

摘　　要：目的评价腺苷负荷超声心动图(ASE)结合二维斑点追踪显像(STE)对缺血心肌的诊断价值。方法 36只家兔分为两组,其中模型组26只,对照组10只。模型组家兔开胸并不全结扎左前降支,对照组家兔开胸但不损伤左前降支。1个月后行腺苷负荷试验,测量各节段心肌的最大收缩期径向应变(PRS),以冠脉造影结果为金标准,评价ASE结合STE诊断缺血心肌的敏感性和特异性。结果对照组心肌各节段的PRS随着腺苷剂量的增加不断增大,差异无统计学意义(P>0.05)。模型组缺血节段心肌的PRS在80μg/(kg.min)时增加,而100μg/(kg.min)时PRS明显降低(P<0.05)。以冠脉造影结果为金标准,ASE结合STE识别缺血心肌的敏感性为87.8%,特异性为87.8%。结论 ASE结合STE可促进缺血心肌的检出,为心肌缺血的诊断提供许多有价值的信息。Objective To evaluate the value of two-dimensional speckle tracking echocardiography（STE） combined with adenosine stress echocardiography（ASE） in myocardial ischemia diagnosis.Methods 36 rabbits were divided into two groups,model group（26 rabbits） and control group（10 rabbits）.The rabbits of model group were opened chest and maked astenosis of left anterior descending coronary artery.While the rabbits of control group were opened chest without ligated left anterior descending coronary artery.One month after all the rabbits were treated,ASE were carried out.Then the peak systolic radial strain（PRS） of each segment were measured.The sensitivity and specificity of STE combined with ASE were evaluated based on angiocardiography which was the gold standard.Results In control group,PRS of each segment enhanced,with the dose of adenosine increasing.But there was no significant difference among PRS of each segment（P 0.05）.In model group,PRS enhanced on 80 μg/（kg·min）,but decreased on 100 μg/（kg·min）（P 0.05）.The sensitivity and specificity of STE combined with ASE in myocardial ischemia diagnosis were 87.8%,87.8% respectively.Conclusion ASE combined with STE can improve the detection of myocardial ischemia,offering many important messages in ischemic myocardium diagnosis.

关 键 词：腺苷 超声心动图 负荷试验 二维斑点追踪显像 缺血心肌 心血管造影术 

分 类 号：R445.1[医药卫生—影像医学与核医学]