超声心动图对冠状动脉硬化性心脏病的诊断价值——与冠状动脉造影对比  

Value of echocardiography in the diagnosis of coronary artery disease compared with coronary arteriography

作　　者：耿斌[1] 曹铁生[1] 段云友[1] 

机构地区：[1]第四军医大学唐都医院超声诊断科,陕西西安710038

出　　处：《第四军医大学学报》2000年第8期1031-1032,共2页Journal of the Fourth Military Medical University

摘　　要：目的　通过对冠心病 (CAD)的超声心动图 (ECHO)与冠状动脉造影对比 ,来探讨 ECHO对 CAD诊断的价值 .方法　对 71例 CAD进行 ECHO检查 ,并与造影进行对比 .结果　 ECHO对 CAD诊断的敏感性较低 ,单枝、多枝病变和总的阳性率分别为 35 .7% ,6 5 .1%和 5 3.5 % ;ECHO阳性患者的 CAD病变程度较为严重 ,且多为多枝病变 ,其狭窄程度>90 .0 % ;如果为单枝病变 ,则冠状动脉 (CA )的狭窄程度已接近闭塞或完全闭塞 ;ECHO阳性的冠造 Gensini's评分为5 3.5 ,而阴性的冠造 Gensini's评分为 13.3,两者有显著差异(P<0 .0 1) ;室壁运动评分与冠造评分之间存在显著的线性关系 ,为显著性正相关 (r=0 .796 ,P<0 .0 1) ;当以 RCA病变为主时 ,ECHO无阳性发现 .结论　 ECHO对 CAD诊断的敏感性虽然较低 。AIM To investigate the value of echocardiography (ECHO) in the diagnosis of coronary artery disease (CAD) in comparison with coronary arteriography (CAG). METHODS ECHO was performed in 71 cases of patients with CAD and compared with CAG. RESULTS ECHO had a considerably low sensitivity for CAD in the diagnosis, 35.7% for 1 vessel CAD and 65.1% for multiple vessel CAD. The total sensitivity of ECHO for CAD diagnosis was 53.5%. When ECHO was positive, the CAD diagnosed tended to be multiple vessel and the degree of stenosis was usually over 90 0%. The CAD diagnosed was a 1 vessel case, the main coronary artery might have been completely or almost completely occluded. Moreover, the patients with positive ECHO had a higher Gensini's scores than subjects with negative ECHO (53.5 vs 13.3, P <0.01): the WMS was significantly positively correlated with Log (1+Gensini's scores). ECHO was always found to be negative if the atherosclerosis was mainly involved in right coronary artery. CONCLUSION Although sensitivity of ECHO in the diagnosis for CAD is considerably low, its value in evaluating the severe degree of CAD has to be paid more attention to.

关 键 词：超声心动图 冠心病 冠状动脉造影术 

分 类 号：R541.404[医药卫生—心血管疾病] R540.45[医药卫生—内科学]