论文部分内容阅读
目的探讨多巴酚丁胺负荷超声心动图(DSE)结合应变率显像(SRI)技术中舒张功能参数变化诊断冠心病的临床价值。方法28例临床疑诊为冠心病的患者接受DSE试验并行舒张期SRI参数分析,以冠状动脉造影结果为金标准,比较DSE负荷下二维目测法及SRI检出冠心病患者舒张功能异常的敏感性及特异性。结果狭窄冠状动脉供应心肌节段在峰值剂量(40μg·kg-1·min-1)DSE负荷下与静息状态及小剂量(10~20μg·kg-1·min-1)DSE负荷相比,舒张早期应变率显著降低,舒张开始时间显著延长。DSE检出冠心病患者舒张功能异常的敏感性、特异性、准确率分别为84%、86%及86%,DSE-舒张早期应变率和舒张开始时间检出冠心病患者舒张功能异常的敏感性分别为91%和93%,特异性分别为87%和85%,准确率分别为89%和90%。结论DSE结合SRI中舒张功能参数变化可提高DSE检出冠心病患者舒张功能异常的敏感性,能定量评价冠心病患者DSE状态下的心肌舒张运动状态,具有一定的临床价值。
Objective To investigate the clinical value of diastolic function parameters in diagnosis of coronary heart disease (CAD) with dobutamine stress echocardiography (DSE) combined with strain rate imaging (SRI). Methods Twenty-eight patients with clinically suspected coronary heart disease underwent DSE and parallel diastolic SRI parameters. The results of coronary angiography were taken as the gold standard. Two-dimensional visual inspection under DSE and SRI were performed to detect diastolic dysfunction in patients with coronary heart disease Sexual and specific. Results Compared with resting state and small dose (10 ~ 20μg · kg-1 · min-1) DSE load at the peak dose (40μg · kg-1 · min-1) Early diastolic strain rate was significantly reduced, diastolic onset time was significantly prolonged. The sensitivity, specificity and accuracy of DSE in detecting diastolic dysfunction in patients with coronary heart disease were 84%, 86% and 86% respectively. The sensitivity of DSE-diastolic early strain rate and diastolic onset time to diastolic dysfunction in patients with coronary heart disease 91% and 93%, respectively, with a specificity of 87% and 85%, respectively, with an accuracy of 89% and 90%, respectively. Conclusions DSE combined with the change of diastolic function parameters in SRI can improve the sensitivity of DSE in detecting diastolic dysfunction in patients with coronary heart disease, and can quantitatively evaluate the state of myocardial diastolic movement in patients with coronary heart disease under DSE. It has certain clinical value.