超声心动图多巴酚丁胺负荷试验对冠状动脉病变严重程度的预测价值

THE VALUE OF DOBUTAMINE ECHOCARDIOGRAPHY STRESS TEST FOR PREDICTING THE EXTENT OF CORONARY ARTERY DISEASE

用超声心动图多巴酚丁胺负荷试验（ＤＥＳＴ）检查了４５例急性心肌梗塞恢复期病人。依据分级负荷试验中左心室舒张功能指标──二尖瓣室间隔角（ＭＳＡ）的变化趋势分为组１（ＭＳＡ增大）和组２（ＭＳＡ变小）。静息状态下，两组间Ｘ线左室造影的心功能指标有显著性差异。静息状态和ＤＥＳＴ中，两组间ＭＳＡ均有显著性差异。组１病人中多支血管病变１２例（１２／１５），组２病人中有１４例（１４／３０）；ＤＥＳＴ中ＭＳＡ动态变化对多支血管病变的阳性和阴性预测值分别为８０．０％和５３．３％。

Forty-five convalescent patients with acute myocardial infarction were studied by dobutamine echocardiography stress test (EDST). According to the mitral septal angle (MSA) in resting condition, the patients were divided into 2groups, group 1 consisted of 15 cases of increased MSA,and group 2, 30 cases of decreased MSA. The indexes of left ventricular function in resting condition determined on the findings of X-ray cardiogram showed significant differences between the 2 groups. DEST revealed that the increased MSA in group 1 in resting condition tended to increase during the test, but the decreased MSA in group 2 further decreased during the test significantly and dose-dependently. Coronary angiography showed there were 12 cases of multivascular lesion in group 1 (12/5) and 14 in group 2 (14/30). Hence the positive and negative values of the dynamic change of MSA during DEST for multivascular lesion (the extent of coronary artery disease) were 80.0% and 53.3% respectively.