多巴酚丁胺负荷超声心动图诊断冠心病的临床价值

Clinical value of diagnosis of coronary heart disease by ultrasound cardiogram with dobutamine load

目的:研究多巴酚丁胺(DBA)负荷超声心动图(DSE)诊断冠心病的临床实用价值。方法:临床诊断为冠心病患者和正常对照者各37例,DBA每隔3min以剂量递增的方式持续静注(5、10、20、30、40μg/kg·min),同时用二维超声心动图重点观察室壁运动的变化,采用16节段左室分析方法对室壁各节段半定量计分,计算室壁运动得分指数(WMSI)。结果:用药后心率、收缩压、舒张压、心率与收缩压的乘积(RPP)均增高,冠心病组WMSI明显增加(P<0.01)。DSE诊断冠心病的敏感性为86.5%、特异性为89.1%、准确性为78.12%。不良反应有心慌、恶心以及室早,无需特殊处理。结论:DSE诊断冠心病安全、可靠,具有重要的临床实用价值。

Objective：To study the clinical practical value of ultrasound cardiogram with dobutamine load（DSE）in diagnosis of coronary heart disease. Methods： 37 cases with coronary heart disease while other 37cases as normal control group, each receives constant dobutamine（ DBA）venous instillation every 3 min in patlern of dosage progressive increase（5.10.20.30.40 μg/kg · min）, 2-dimension ultrasound cardiogram is applied to observe changes of ventricular wall motion in emphasis; 16 segment left ventricle analysis method is applied to semi rationally count scores of each segment of ventricular wall and lo calculate ventricular wall motion score index（WMS1）. Results： Heart rate, systolic pressure, diastolic pressure, and product of multiplication of heart rate and systolic pressure（RPP）all increases,WMSl obviously increases in coronary heart disease group（P〈 0. 01 ）. Sensitivity, Specificity and accuracy of coronary heart disease diagnosis by DSE are 86.5 %, 89.1% and 78.12% respectively, Fluster, nausea and ventricular premature heals are common abnormal reaction and need no special treatment . Conclusions： Diagnosis of coronary heart disease by uhrasound cardiogram with dobutamine load is safe and reliable, and have important clinical practical value.