摘要
目的探讨在多巴酚丁胺负荷试验下应用超声应变率显像技术(SRI)检测心肌缺血的临床价值。方法对临床可疑冠心病者50例全部行多巴酚丁胺负荷试验和冠状动脉造影检查,根据冠状动脉造影结果分为冠心病组和正常组,分别在静息状态、各级负荷状态下于心尖两腔及四腔观应用SRI技术测量左室前壁中段和侧壁中段的收缩期峰值应变率,并与冠状动脉造影结果相对照。结果正常组心肌各节段的收缩期峰值应变率随多巴酚丁胺剂量的增加而增加(P<0.05),峰值负荷时应变率达最大;冠心病组缺血节段心肌的收缩期应变率在小剂量时增加,峰值剂量40μg·kg-1·min-1时应变率明显降低(P<0.05)。应变率检测缺血节段的敏感性和特异性分别为90.0%和91.7%。结论应变率显示结合多巴酚丁胺负荷试验会提高心肌缺血的检出率。多巴酚丁胺负荷剂量为40μg·kg-1·min-1时,应变率对心肌缺血的检出最为敏感。
Objective To assess the value in detecting ischemic myocardium by strain rate imaging(SRI) combined with dobutamine stress echocardiography(DSE). Methods Fifty subjects with suspected coronary artery disease(CAD) underwent DSE and coronary angiography. According to the results of coronary angiography, all subjects were divided into two groups: CAD group and normal group. The systolic peak strain rate was respectively measured on middle segment of the left ventricular anterior wall and lateral wall from apical four chamber and two chamber view in rest and every stress stage, and their results were compared with those from coronary angiography. Results In normal group, the systolic peak strain rate values increased correspondingly with dobutamine dose(P<(0.05)), reaching the highest values at the peak dose of dobutamine. In CAD group, strain rate values increased at low dose, and significantly reduced ((P<)(0.05)) at peak dose 40 μg·kg^(-1)·min^(-1).The sensitivity and specificity of SRI with DSE for detecting ischemic myocardium were (90.0)% and (91.7)%, respectively. Conclusions SRI combined with DSE will increase the prevalence of ischemic myocardium. In 40 μg·kg^(-1)·min^(-1) dose, strain rate was the most sensitive to detect the ischemic myocardium.
出处
《中华超声影像学杂志》
CSCD
2005年第5期334-337,共4页
Chinese Journal of Ultrasonography
