多巴酚丁胺负荷定量组织速度成像诊断老年冠心病的临床研究

摘要

Objective To examine the sensitivity, specificity and accuracy of dobutamine stress quantitative tissue velocity imaging(DSE+QTVI) in detecting coronary artery disease (CAD) in patients ≥60 years old.Methods Patients underwent DSE+ QTVI, and accepted coronary angiography in two weeks.Peak tissue velocity (Vpeak) in different dobutamine stress stations was measured and analysed during systolic period in mid-segments of left ventricle walls.Results Compared with coronary angiography (CAG), the sensitivity, specificity and accuracy of Vpeak for detection CAD in the elderly patients were 82.3 ％ 、61.7 ％ 、72.4 ％.At the dobutamine dose of 20 ug/kg.min, Vpeak had achieved maximum sensitivity, specificity(80.4 ％, 81.5 ％).Vpeak has higher specificity in detecting three coronary vessels.Conclusions Quantitative dobutamine stress tissue velocity imaging is a safe, effective and non-invasive technique and has higher sensitivity and specificity in detecting CAD in old patients (≥60 years old).%目的 探讨多巴酚丁胺负荷超声心动图(DSE)与定量组织速度成像(QTVI)相结合诊断老年冠心病的临床价值.方法 98例疑似冠心病老年患者行DSE+QTVI检查,测定不同多巴酚丁胺负荷剂量时左室各节段室壁中段收缩期心肌运动峰值速度(Vpeak),2周内完成冠状动脉造影(CAG)检查.结果 与CAG相比,Vpeak诊断老年人冠心病的敏感性、特异性、精确性分别为82.4%、61.7%、72.4%,Vpeak在多巴酚丁胺20μg/(kg·min)负荷量时其诊断的敏感性和特异性最高,分别为80.4%、81.5%.对于3支冠脉血管的定位诊断均表现为高特异性.结论 多巴酚丁胺负荷定量组织速度成像是一项安全、有效、无创诊断老年冠心病的方法,具有较高的敏感性和特异性.