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目的 评价心肌血流灌注与室壁运动 (WM )对预测冠状动脉疾病 (CAD)的应用价值。方法 用间歇二次谐波脉冲反转显像技术 ,对 48例经冠状动脉造影证实的CAD患者行静脉心肌声学造影(MCE)。采用 16节段划分法 ,进行目测半定量心肌造影计分 (MCS) :回声均匀性增强 ,显影时间≤ 90s为1分 ;回声低淡不均匀 ,显影延时 (>90s)为 0 .5分 ;充盈缺损为 0分。室壁运动计分 (WMS) :运动正常、减弱、无运动及矛盾运动分别为 1、2、3、4分。结果 MCE、WM和两者联合应用预测CAD均具有高度的敏感性、特异性和准确性。MCE的敏感性和准确性均高于WM (均 P <0 .0 5)。联合应用MCE和WM的敏感性显著高于WM(P <0 .0 0 1) ,准确性也高于WM (P <0 .0 5) ,与MCE相比敏感性和准确性差异无显著性意义 (均P >0 .0 5)。 3种方法具有类似的特异性 (均P >0 .0 5)。MCS与WMS的等级相关r =-0 .58,P <0 .0 0 1。两者的符合率为 78%。结论 MCE、WM和两者联合应用预测CAD均具有高度的敏感性、特异性和准确性。MCE和MCE +WM预测CAD比WM更敏感和准确。局部心肌血流灌注与室壁运动有较好的符合率 ,且两者的异常程度也有一定的相关性 ,因此MCE WM相匹配的室壁节段比不匹配的节段更能反映是否存在冠状动脉狭窄
Objective To evaluate the value of myocardial perfusion and ventricular wall motion (WM) in predicting coronary artery disease (CAD). Methods Intravenous myocardial contrast echocardiography (MCE) was performed in 48 CAD patients confirmed by coronary angiography with intermittent second harmonic impulse inversion imaging. Visual inspection of semi-quantitative Myocardial Scintigraphy (MCS) was performed using a 16-segment demarcation method: the echogenicity was enhanced and the development time was 90 s for 1 minute; the echogenicity was low and uneven, and the development delay (> 90 s) was 0.5 Filling defect is 0 points. Wall motion score (WMS): normal exercise, weakened, no exercise and contradictory movements were 1,2,3,4 points. Results The combined application of MCE, WM and CAD in predicting CAD was highly sensitive, specific and accurate. The sensitivity and accuracy of MCE were higher than that of WM (P <0.05). The sensitivity of combined application of MCE and WM was significantly higher than that of WM (P <0. 01) and the accuracy was also higher than that of WM (P <0.05). There was no significant difference in sensitivity and accuracy between MCE and WM Significance (all P> 0.05). Three methods had similar specificity (P> 0.05). Correlation of MCS with WMS grade r = -0.58, P <0.001. The coincidence rate of both is 78%. Conclusion The combined application of MCE, WM and CAD in predicting CAD are highly sensitive, specific and accurate. MCE and MCE + WM predict CAD more sensitive and accurate than WM. Local myocardial perfusion and wall motion have a good coincidence rate, and the degree of abnormality between the two have some relevance, so MCE WM matches the wall segment more than does not match the segment reflects the presence or absence of coronary Artery stenosis