摘要
目的评价腺苷超声负荷试验诊断冠心病的敏感性、特异性和安全性。方法对58例临床诊断或可疑冠心病患者进行腺苷超声负荷试验,以出现节段性室壁运动异常(wall motion abnormality)为阳性;试验后1周内行冠脉造影,以3支主要血管至少有1支或主要初发支管径狭窄≥50%为阳性;以冠脉造影结果为金标准评价腺苷超声负荷试验的敏感性和特异性。结果26例冠脉造影阳性患者中20例腺苷超声负荷试验阳性,6例阴性;32例冠脉造影正常患者中5例腺苷超声负荷试验阳性,27例阴性。冠脉造影见病变血管42支,正常132支;腺苷超声负荷试验推断病变血管34支,23例与冠脉造影符合,正常140支。腺苷超声负荷试验诊断冠心病的敏感性为76.9%,特异性为84.4%;判断血管病变的敏感性为54.7%,特异性为85.6%。不良反应发生率为91.4%,症状轻微,患者均能耐受,无严重不良反应发生。结论腺苷超声负荷试验诊断冠心病安全可靠,提高了超声诊断冠心病的准确性,具有较高的临床应用价值。
Objective To assess the sensitivity, specificity and safety of adenosine stress echocardiography in diagnosis of coronary artery disease （CAD）. Methods Adenosine stress echocardiography was performed in 58 suspectable and diagnostic CAD patients. Positive criterion was defined as the appearance of wall motion abnormality. Coronary arteriography was conducted one week after the test. Results Adenosine stress echocardiography was positive in 20 out of 26 positive CAD patients, and 5 out of 32 normal patients by coronary arteriography. Coronary arteriography showed lesions in 42 branches of blood vessels, normal in 132 branches, adenosine stress echocardiography judged lesions in 34 branches, 23 cases corresponding with the result from coronary arteriography, negative in 140 branches. The total sensitivity of this test was 76.9 % and the total specificity was 84.4 %. The sensitivity for detection of each coronary artery lesion was 54.7 % and the specificity was 85.6 %. The rate of side effect was 91.4 %. Side effects due to adenosine infusion were 91.4%, but always minimal and well tolerated by the patients and there were no severe reactions. Conclusion Adenosine stress echocardiography can be safely performed in suspectable CAD patients with high sensitivity and specificity.
出处
《河北医科大学学报》
CAS
2005年第5期347-349,共3页
Journal of Hebei Medical University
基金
河北省科技厅自选项目(42761208)
