摘要
目的 探讨小剂量多巴酚丁胺负荷超声心动图（ ＬＤＤＳＥ） 检测冬眠心肌的价值，并分析冬眠心肌的超声心动图特征；结合冠脉造影资料评价冠状动脉病变程度和范围对ＬＤＤＳＥ 估测心肌存活的影响；分析ＬＤＤＳＥ 时血流动力学的变化，评价其安全性。方法 应用ＬＤＤＳＥ 前瞻性研究了６５ 例行ＣＡＢＧ的冠心病患者，按１６ 节段左室分析方法半定量评价室壁运动。结果 ＬＤＤＳＥ 估测存活心肌的敏感性为７８ ．３ ％ ，特异性８８ ．４ ％ ，ＰＰＶ ８４ ．２ ％ ，ＮＰＶ８３ ．８ ％ ，准确性８４ ．０ ％ 。有收缩功能储备组和无收缩功能储备组冠状动脉病变的支数、有无冠脉闭塞和侧支循环无明显差别。最常见的副反应是室性早搏，发生率５６ ．９ ％ 。结论 ＬＤＤＳＥ 时的收缩功能储备对术后局部室壁运动的恢复具有较高的预测价值；冠脉造影所示病变程度和范围对估测心肌存活有一定局限性；ＬＤＤＳＥ 是一种的安全、简便、价廉、可广泛应用的无创性估测存活心肌的方法。
Objective To accesse the value of low dose dobutamine stress echocardiography(LDDSE) in identifying hibernating myocardium,analysis echo characteristics of hibernating myocardium and the influence of prevalence of narrowed coronary artery by angiography.Methods LDDSE was performed in 65 patients referred to CABG,and all wrer examined postoperatively.LV wall motion was analyzed semi quantitatively by dividing LV into 16 segments.Results The sensitivity,specificity,PPV,NPV and accuracy of LDDSE in the identification of viable myocardium are 78.3 %, 88.4 %, 84.2 %, 83.8 % and 84.0 %,respectively.There were no differences of the prevalence of number of narrowed coronary arteries,occluded arteries and collaterals between patients with and without contractile reserve.The most common side effect during LDDSE was ventricular premature ( 56.9 %).Conclusions LDDSE is an safe,simple,cost effective and widely available method in identifying hibernating myocardium and predicting function improvement after revascularization,while coronary artery angiography alone may have limited value.
出处
《中华超声影像学杂志》
CSCD
2000年第1期21-23,共3页
Chinese Journal of Ultrasonography
基金
卫生部基金
关键词
超声心动图
多巴酚丁胺
冠心病
Echocardiography
Dobutamine
Myocardium
Coronary disease
