多巴酚丁胺负荷超声结合硝酸异山梨酯检测冠心病患者存活心肌

Dobutamine stress echocardiography combined with Isoket detecting viable myocardium in patients with coronary artery disease

目的 探讨硝酸异山梨酯 (Isoket)对多巴酚丁胺负荷超声心动图检测的影响。方法 3 7例患者依据冠状动脉造影的结果分为 3组 :对照组 12例、冠心病Ⅰ组 15例和冠心病Ⅱ组 10例 ,其中冠心病Ⅱ组行标准多巴酚丁胺负荷超声 (DSE)结合Isoket ,其余两组行标准DSE ,以冠状动脉介入性治疗 (PCI)后室壁运动改善的结果作为评价DSE的标准。结果 冠心病Ⅰ组室壁运动双相反应的发生率为 62 .5 % ,存活心肌检出敏感性为61% ,特异性为 76% ;冠心病Ⅱ组室壁运动双相反应的发生率为 72 .2 % ,存活心肌检出敏感性为 82 % ,特异性为88% ;冠心病Ⅱ组存活心肌的检出率和敏感性明显高于冠心病Ⅰ组。结论 标准DSE是检测存活心肌的可靠方法 ;Isoket可提高DSE存活心肌检出率。

Objective To observe the effect of Isoket on standard dobutamine stress echocardiography(DSE).Methods Thirty-seven patients were divided into three groups according to the results of quantitative coronary angiography(QCA):the control group(CON) including 12 patiens,the coronary artery disease group 1(CAD1) including 15 patients,and the coronary artery disease group 2(CAD2) including 10 patients.Among the three group,the DSE+Isoket was done in CAD2,while the standard DSE was done in the other two groups.The improvement of segments of left ventricular after percutaneous transluminal intervention(PCI) was looked as the standard evaluating DSE.Results Isoket could increase heart rate and decrease systolic blood pressure,but could hardly affect diastolic blood pressure.The rate of biphysic response was 62.5% in group CAD1,and the sensitivity of detecting viable myocardium was 61%,while the specificity was 76%.In group CAD2,the rate of biaphysic response was 72.2% ,and the sensitivity of detecting viable myocardium was 82%,while the specificity was 88%.The rate detecting viable myocardium and sensitivity was improved significantly in group CAD2.Conclusions DSE combined with Isoket was beneficial for detecting viable myocardium.