腺苷超声心动图负荷试验诊断冠心病的应用价值

Clinical Value of Adenosine Stress Echocardiography in Diagnosis of Coronary Artery Disease

目的 评价腺苷超声心动图负荷试验(ASE)诊断冠心病的敏感性、特异性与安全性。方法 临床拟诊冠心病(CAD)患者100例,分别静脉注射腺苷140μg/(kg·min),用药时间6 min,总剂量0.84 mg/kg,并同时记录室壁运动、患者症状和不良反应等。左室16节段中出现室壁运动异常为阳性。64例患者于试验后1周内行冠状动脉造影,并以其为金标准,计算ASE的敏感性和特异性等。结果 ASE诊断CAD的敏感性为68.8%, 特异性为81.2%,准确性为75%。诊断CAD单支、双支和三支病变的敏感性分别为60.6%、70.0%和83.3%。ASE不良反应发生率为59.0%,但症状轻微,无严重不良反应。结论 ASE是一种较理想的诊断CAD的无创检查方法。

Objective The aim of the study was to assess the clinical value of adenosine stress echocardiography in diagnosis of CAD. Methods Adenosine stress echocardiography(ASE) was performed in 100 suspectable CAD patients with infusion of adenosine 140 μg/(kg·min) in 6 min. Left ventricular wall motion was recorded during the procedure. Positive criterion was defined as the appearance of wall motion abnormality(WMA). And then among them 64 patients underwent the coronary angiography a week after ASE. Coronary angiography was taken as the golden standard for CAD and comparion of ASE. Results The total sensitivity of this ASE was 68.8% and the total specificity was 81.2% in diagnosis of CAD. Furthermore the sensitivity for detection of myocardial ischemia in one, two and three-vessel CAD sub-groups were 60.6%, 70.0% and 83.3% respectively. Side effects due to adenosine in fusion were always minimal and well tolerated by the patients. Conclusion Adenosine stress echocardiography can be safely performed in suspectable CAD patients with high sensitivity and specificity.