多巴酚丁胺超声心动图联合平板运动心电图对冠心病的筛查价值  

The Value of Dobutamine Echocardiography Combined with Treadmill Electrocardiogram in Screening Coronary Heart Disease

作　　者：李琳 李影 柴静 帅燕 Li Lin;Li Ying;Chai Jing;Shuai Yan(Department of Electrocardiology,Central Hospital of Shanxian County in Shandong Province,Shanxian 274300,China)

机构地区：[1]山东省单县中心医院心电检查科,山东单县274300

出　　处：《中国运动医学杂志》2020年第3期173-177,共5页Chinese Journal of Sports Medicine

摘　　要：目的:探讨多巴酚丁胺超声心动图联合平板运动心电图对冠心病的筛查价值。方法:选择2017年6月至2018年12月期间156例疑诊冠心病患者为研究对象,全部患者采用多巴酚丁胺超声心动图、平板运动心电图和冠脉造影检查。以冠脉造影检查结果作为金标准,比较不同检查方法对冠心病的筛查灵敏度、特异度、阳性预测值、阴性预测值和准确度的差异,观察不良反应情况。结果:冠脉造影、多巴酚丁胺超声心动图、平板运动心电图、多巴酚丁胺超声心动图联合平板运动心电图对冠心病的筛查阳性率分别为76.28%、57.69%、57.05%、75.66%。冠脉造影检查和多巴酚丁胺超声心动图联合平板运动心电图检查对冠心病的筛查阳性率明显高于多巴酚丁胺超声心动图和平板运动心电图检查(P<0.05)。多巴酚丁胺超声心动图联合平板运动心电图对冠心病筛查灵敏度、阴性预测值和准确度均高于多巴酚丁胺超声心动图和平板运动心电图(P<0.05)。全部患者检查期间无心肌梗死和病死等不良事件发生,16例发生心绞痛,含服硝酸酯类药物后缓解;15例出现胸闷、头昏、头痛、干咳、皮肤潮红、恶心、气短、心悸等不适,并在停药后缓解。结论:多巴酚丁胺超声心动图联合平板运动心电图对冠心病的筛查价值显著。Objective To investigate the value of the dobutamine echocardiography combined with treadmill electrocardiogram in screening the coronary heart disease.Methods One hundred and fifty-six patients suspected of the coronary heart disease between June 2017 and December 2018 were selected and underwent the dobutamine echocardiography,treadmill electrocardiogram and coronary angiography.The coronary angiography results were taken as the gold standard.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of different screening methods were compared,and their adverse reactions were observed.Results The screening positive rates of the coronary angiography,dobutamine echocardiography,treadmill electrocardiogram,and dobutamine echocardiography combined with the treadmill electrocardiogram were 76.28%,57.69%,57.05%and 75.66%respectively,with that of the first and forth method significantly higher than the other two.Moreover,the sensitivity,negative predictive value and accuracy of the dobutamine echocardiography combined with the treadmill electrocardiogram were significantly higher than the latter(P<0.05).During the examination,no myocardial infarction and death occurred,and 16 patients suffered from angina and was relieved after taking nitrates,while another 15 patients had chest tightness,dizziness,headache,dry cough,skin flushing,nausea,breath shortness and palpitations and other discomfort,which disappeared after drug withdrawal.Conclusion The dobutamine echocardiography combined with the treadmill electrocardiogram is of significant values in the screening of the coronary heart disease.

关 键 词：冠心病 超声心动图 平板运动心电图 多巴酚丁胺 筛查 

分 类 号：R541.4[医药卫生—心血管疾病]