解剖 M型超声心动图对冠状动脉病变的诊断价值  

The clinical diagnostic value of anatomic M -mode echocardiography in coronary artery diseases

作　　者：观志强[1] 郑宝群[1] 陈畅[2] 陈晓霞[1] 钟雪菁 郑英杰[1] 

机构地区：[1]汕头大学医学院第一附属医院超声科,广东省汕头515041 [2]汕头大学医学院第一附属医院心内科,广东省汕头515041

出　　处：《中国基层医药》2015年第23期3521-3523,共3页Chinese Journal of Primary Medicine and Pharmacy

基　　金：广东省科技计划项目（2014A020212414）

摘　　要：目的：探讨解剖 M型超声心动图（AMM）技术评价冠心病患者相对应冠状动脉血管病变的应用价值。方法采用 AMM技术检测临床怀疑冠心病患者共44例，先行普通超声检查，再应用 AMM技术采集相应室壁节段搏幅、厚度，计算室壁增厚率；再行冠状动脉造影检查，根据冠状动脉造影结果，定义受检者血管狭窄≥50％归入冠心病组，造影结果完全正常纳入健康对照组。比较冠心病组与健康对照组各参数间差别。结果健康对照组 AMM室壁节段搏幅＞5 mm 占78．67％，增厚率＞30％占99．13％。冠心病组室壁节段搏幅＜4 mm 占61.14％，搏幅＜5 mm 占93．47％，增厚率＜30％占88．43％。AMM灵敏度77．47％，特异度90．00％，准确度77．39％。结论AMM的增厚率指标能反映室壁运动情况，与冠心病患者血管病变有良好的相关性，适合在临床中推广使用。Objective To investigate the clinical value of anatomic M -mode echocardiography （AMM） for pristine diagnosis of myocardial ischemia in patients with coronary heart diseases （ CAD ）. Methods 44 inner patients who were suspected as CAD were detected. Ordinary ultrasound was performed first. The ventricular segmental wall thickness and amplitude were measured by AMM. Then, we got the ventrieular wall thickening fractions. All subjects should take the coronary angiography after the ultrasound examination in 1 - 3 days. Patients with the vascular stenosis rate ≥50% were defined as the CAD group, patients with the completely normal angiographic results were included in the normal control group according to the results of angiography. The parametric differences between the patients and the normal control subjects were compared. Results In the normal control subjects, the ventricular segmental wall amplitude 〉 5mm accounted for 78.67%, the ventricular wall thickening fractions 〉 30% accounted for 99.13%. But in CAD group,the ventricular segmental wall amplitude 〈4mm accounted for 61.14%, 〈5mm accounted for 93.47%, the abnormal ventricular wall thickening fractions 〈 30% accounted for 88.43%. The sensitivity, specificity,accuracy of AMM were 77.47% , 90. 00%, 77. 39% respectively. Conclusion The ventricular wall thickening fractions of AMM has quite significant correlation with morbid blood vessel in patients with CAD, they are effective reference indicators to evaluate the left ventricular wall motion quantitatively.

关 键 词：冠状动脉疾病 超声心动描记术 三维 

分 类 号：R540.45[医药卫生—心血管疾病]