运动负荷超声心动图诊断冠状动脉严重病变假阴性结果的影响因素分析  

Analysis of Risk Factors Associated With False Negative Results of Exercise Stress Echocardiography in the Diagnosis of Significant Coronary Artery Lesions

作　　者：张博 潘晓芳 隋春兴 贾晓东 沈佳奇 孙飞一 于昊 盛一洁 ZHANG Bo;PAN Xiaofang;SUI Chunxing;JIA Xiaodong;SHEN Jiaqi;SUN Feiyi;YU Hao;SHENG Yijie(Department of Ultrasound Imaging,Dalian Municipal Central Hospital Affliated to Dalian Medical University,Dalian,116033,Liaoning,China)

机构地区：[1]大连医科大学附属大连市中心医院超声影像科,辽宁省大连市116033 [2]大连医科大学附属大连市中心医院心内科,辽宁省大连市116033

出　　处：《中国循环杂志》2021年第8期756-761,共6页Chinese Circulation Journal

摘　　要：目的:探讨运动负荷超声心动图(ESE)诊断冠状动脉严重病变假阴性结果的相关影响因素。方法:纳入2014年10月至2020年8月期间因疑似稳定性冠心病(SCAD)在大连医科大学附属大连市中心医院进行ESE和冠状动脉造影(CAG)检查的605例患者。应用多因素Logistic回归分析影响ESE诊断冠状动脉严重病变假阴性结果的临床及超声心动图因素。结果:以CAG为金标准,ESE诊断严重冠状动脉病变出现41例假阴性结果。多因素Logistic回归分析显示,在ESE阴性患者中,男性(OR=5.066,95%CI:1.663~15.436,P=0.004)和糖尿病(OR=3.493,95%CI:1.414~8.629,P=0.007)为假阴性结果的独立相关因素;在CAG阳性的冠状动脉血管中,冠状动脉狭窄70%~<90%(OR=5.331,95%CI:2.616~10.865,P<0.001)、伴有侧支循环(OR=3.867,95%CI:1.485~10.073,P=0.006)和左前降支病变(OR=0.490,95%CI:0.286~0.838,P=0.009)为假阴性结果的独立相关因素。结论:男性、糖尿病、冠状动脉狭窄70%~<90%、伴有侧支循环和左前降支病变为ESE诊断SCAD患者的冠状动脉严重病变假阴性结果的独立相关因素。Objectives:To explore the risk factors associated with false negative results of exercise stress echocardiography(ESE)in diagnosing stable coronary artery disease(SCAD)significant lesions.Methods:A total of 605 patients who underwent ESE and coronary angiography(CAG)in Dalian Municipal Central Hospital from October 2014 to August 2020 were enrolled in this study.Multivariate logistic regression was used to analyze the clinical and echocardiographic risk factors of false negative ESE results of significant coronary artery lesions.Results:With CAG as the gold standard,there were 41 cases of ESE diagnosed false negative results of significant coronary artery lesions.Multivariate logistic regression analysis showed that male gender(OR=5.066,95%CI:1.663-15.436,P=0.004)and diabetes mellitus(OR=3.493,95%CI:1.414-8.629,P=0.007)were independent risk factors for false negative ESE results.The degree of coronary artery stenosis between 70%and<90%(OR=5.331,95%CI:2.616-10.865,P<0.001),presence of collateral circulation(OR=3.867,95%CI:1.485-10.073,P=0.006)and anterior descending branch lesions(OR=0.490,95%CI:0.286-0.838,P=0.009)were independent CAG-related risk factors for false-negative ESE results.Conclusions:Male,diabetes,degree of coronary artery stenosis between 70%and<90%,presence of collateral circulation and anterior descending branch lesions are independent risk factors of false negative results in ESE diagnosis of significant SCAD lesions.

关 键 词：稳定性冠心病 冠状动脉狭窄 运动负荷超声心动图 假阴性 

分 类 号：R54[医药卫生—心血管疾病]