彩色室壁动态技术在多巴酚丁胺负荷超声心动图试验诊断糖尿病患者冠心病中的价值

Value d color kinesis in diagnosis of coronary artery disease with diabetes mellitus by dobutmnine stress echocardiography

目的将彩色室壁动态（CK）技术用于多巴酚丁胺负荷超声心动图试验（DSE），并与二雏超声心动图（2DE）目测法比较，评价其实用价值和优越性。方法36例糖尿病并冠心病患者和30例冠心病忠者先后于冠状动脉造影后一个月内完成DSE。（1）分别用2DE和CK技术判断室壁运动状况，比较诊断糖尿病患者并冠心病的敏感性、特异性和准确性。（2）用SPECT作为金标准，采用CK技术定量分析室壁运动。结果（1）CK技术诊断糖尿病患者并冠心病的敏感性和准确性分别是90-5％和91.7％，均高于2DE法。P〈0．05，尤其对单支，二支病变诊断敏感性更高，特异性无显著性差异，分别为93％、89％，P〈O-05。（2）DSE后两组患者非受累部位心内膜移动幅度增加，受累部位则明显减少，后者尤其明显。结论CK技术诊断糖尿病患者井冠心病的敏感性和准确性均高于2DE法，CK技术定量分析法有一定价值。

Objective To assess the color kinosis（CK） ultrasonographic features and advantage in dobutamine stress eehocardiographie test（DSE） ,comparing to 2 - dimensional echocardiography（2DE）Methods The endoeardial motion were measured by CK and 2DE during DSE in 36 coronary artery disease patients with diabetes mellitns and 30 patients with coronary artery disease after coronary arteriography 20 patents underwent SPECT examination. Results Sensitivity and accuracy of CK were 90.5% and 91.7% ,respectively,higher than those of 2DE,P 〈 0.05. especially for singly - or double - coronary disease, there were no significandy different in specificity between two methods ,93% VS 89% p 〉 0.05. The inward motion distance of normal area increased significandy during DSE, p 〈 0.05, in reverse,that of the ischemia area decreased significantly,P 〈 0.05. Conclusion Sensitivity and accuracy of CK were higher than those of 2DE. Quantitative analysis of CK has great value in clinical application.