多巴酚丁胺负荷超声心动图与铊-201SPECT对冠心病的诊断价值研究  

Values of dobutamine stress echocardiography and thallium-201 SPECT in the diagnosis of coronary heart dis⁃ease

作　　者：詹昕 左媛 ZHAN Xin;ZUO Yuan(Department of Ultrasound,Wenzhou Seventh People's Hospital,Wenzhou 325000,China)

机构地区：[1]温州市第七人民医院超声科,浙江温州325000

出　　处：《全科医学临床与教育》2020年第7期588-591,共4页Clinical Education of General Practice

摘　　要：目的探讨多巴酚丁胺负荷超声心动图(DSE)、铊-201单光子发射计算机断层显像(T1-201 SPECT)检测对冠心病的诊断价值。方法选取101例疑似冠心病者为研究对象,均行DSE、T1-201 SPECT、冠状动脉造影(CAG)检查,以CAG显示至少一支冠状动脉狭窄≥50%为冠心病诊断“金标准”。比较CAG阳性组和阴性组基本资料,及不同冠脉狭窄程度室壁运动积分(WMS)和负荷灌注总积分(SSS),并采用ROC曲线分析DSE、T1-201 SPECT检测对冠心病诊断价值。结果CAG阳性组患者高血压、高脂血症、糖尿病比例及吸烟率均明显高于CAG阴性组,差异均有统计学意义(χ2分别=9.54、10.68、13.36、8.47,P均<0.05)。冠心病冠脉重度、中度狭窄患者的WMS和SSS均明显高于轻度狭窄患者(t分别=10.50、5.67、17.65、14.43,P均<0.05),冠心病冠脉重度狭窄患者的WMS和SSS均明显高于中度狭窄患者(t分别=5.41、7.78,P均<0.05)。T1-201 SPECT诊断冠心病的灵敏度、特异度、准确度分别为88.14%、92.86%、90.10%,DSE检查的灵敏度、特异度、准确度分别为84.75%、90.48%、87.13%。结论DSE、T1-201 SPECT检测对冠心病诊断的灵敏度、特异度、准确度均较高,在临床上具有一定应用价值。Objective To explore the diagnostic values of dobutamine stress echocardiography(DSE)and thallium-201 single photon emission computed tomography(T1-201 SPECT)in coronary heart disease.Methods Totally 101 patients with suspected coronary heart disease were selected as the study object,DSE,T1-201 SPECT and coronary arteriongraphy(CAG)were performed in all patients.One coronary artery stenosis≥50%at least shown by CAG as the gold standard for the diagnosis of coronary heart disease.The basic data between CAG positive and negative groups were compared.The wall motion score(WMS)and summed stress score(SSS)among different degree of coronary stenosis,and the diagnostic values of DSE and T1-201 SPECT were analyzed by ROC curve.Results The rates of hypertension,hyperlipidemia,diabetes mellitus and smoking in CAG positive group were significantly higher than those in CAG negative group(χ2=9.54,10.68,13.36,8.47,P<0.05).WMS and SSS of patients with severe and moderate coronary stenosis were significantly higher than those of patients with mild coronary stenosis(t=10.50,5.67,17.65,14.43,P<0.05).WMS and SSS of patients with severe coronary stenosis were significantly higher than those of patients with moderate coronary stenosis(t=5.41,7.78,P<0.05).The sensitivity,specificity and accuracy of T1-201SPECT,DSE for diagnosing coronary heart disease were 88.14%,92.86%,90.10%,84.75%,90.48%,87.13%,respectively.Conclusion The sensitivity,specificity and accuracy of DSE and T1-201 SPECT for diagnosing coronary heart disease are high.

关 键 词：多巴酚丁胺负荷超声心动图 铊-201 单光子发射计算机断层显像 冠状动脉疾病 冠状动脉造影 

分 类 号：R541.4[医药卫生—心血管疾病] R540.45[医药卫生—内科学]