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目的评价腺苷超声心动图负荷试验(ASE)在冠心病诊断中的应用价值。方法52例拟诊冠心病(CAD)患者,分别静脉注射腺苷,剂量为140μg/(kg·min),用药时间6min,总剂量0.84mg/Kg;注射过程观察和记录室壁运动变化、患者血压、心率及不良反应;以左室16节段中出现新的室壁节段运动异常(WMA)为阳性。试验后1周内行冠脉造影,以冠脉造影为金标准,评价腺苷超声心动图负荷试验诊断冠脉病变的敏感性和特异性。结果注射腺苷后超声心动图诊断阳性29例,冠脉造影阳性34例,2项均阳性27例,均阴性16例,ASE诊断CAD敏感性79.4%,特异性88.9%,准确性82.7%,ASE诊断单支、双支、三支血管病变敏感性分别为72.2%、81.8%和100%。对狭窄≥75%病变血管的判断敏感性100%。不良反应发生率80%,症状轻微,患者均能耐受。结论腺苷负荷超声心动图是一种无创的较理想的诊断CAD的检查方法。
Objective To evaluate the value of adenosine echocardiography (ASE) in the diagnosis of coronary heart disease. Methods Fifty-two patients with suspected CAD were randomly assigned to receive adenosine at a dose of 140 μg / (kg · min) for 6 minutes and a total dose of 0.84 mg / kg. The changes of wall motion were observed and recorded during injection. Blood pressure, heart rate and adverse reactions; positive new wall segment abnormalities (WMA) appeared in 16 segments of the left ventricle. Coronary angiography was performed within 1 week after the test. Coronary angiography was used as the gold standard to evaluate the sensitivity and specificity of adenosine echocardiography in the diagnosis of coronary lesions. Results There were 29 cases diagnosed by echocardiography after echocardiography, 34 cases were positive by coronary angiography, 27 cases were positive and 16 cases were negative. The diagnostic sensitivity of ASE was 79.4%, specificity was 88.9%, accuracy was 82.7% The sensitivity of ASE in diagnosing single vessel, double vessel, and triple vessel lesion was 72.2%, 81.8% and 100% respectively. Sensitivity to stenosis ≥75% of diseased vessels is 100%. The incidence of adverse reactions 80%, minor symptoms, patients can tolerate. Conclusion adenosine stress echocardiography is a noninvasive and more ideal method of diagnosis of CAD.