多巴酚丁胺负荷超声心动图结合组织多普勒应变率成像技术诊断老年人冠心病的研究

摘要

目的 探讨多巴酚丁胺负荷超声心动图(DSE)结合组织多普勒应变率成像技术(SRI)诊断老年人冠心病的临床价值.方法 98例老年疑诊冠心病的患者行DSE+SRI检查,测定不同多巴酚丁胺负荷剂量时各心室壁中段收缩期心肌峰值应变率(SRpeak),2周内完成冠状动脉造影(GAG),对比分析SRpeak和GAG对老年人冠心病的诊断价值.结果 与GAG相比,SRpeak诊断老年人冠心病敏感度、特异度、准确度分别为71.7%、82.2%、78.O%;SRpeak在不同多巴酚丁胺负荷剂量时诊断的敏感度和特异度不同,在40μg·kg-1·min-1负荷剂量时最高,分别为75.O%、90.4%;对于三支冠状动脉血管的定位诊断均表现为高特异度.结论 多巴酚丁胺负荷定量应变率成像是一项安伞、有效、无创诊断老年人冠心病的方法.%Objective To investigate the diagnostic value of dobutamine stress echocardiograpy ( DSE) + strain rate imaging (SRI) for detecting coronary artery disease (CAD) in elderly. Methods A total of 98 elderly patients ( ≥60 years) underwent DSE + SRI. All patients completed coronary angiography (CAG) within two weeks after DSE + SRI. Peak strain rate (Srpeak) at different dobutamine dose was measured and analyzed during systolic period in mid-segment of left ventricle wall by echopac 8. 0 workstation. Results According to the results of CAG, the sensitivity, specificity and accuracy of Srpeak for detecting CAD in elderly patients were 71.7% ,82. 2% and 78. 0% , respectively. The sensitivity and specificity at different dobutamine dose were different and at the dose of 40 μg · kg-1 · min-1 , Srpeak achieved maximum sensitivity (75. 0% ) and specificity (90. 4% ). Srpeak had higher specificity for detecting three vessel disease. Conclusions DSE +SRI is a safe, effective and non-invasive method for detecting CAD in elderly.