大剂量多巴酚丁胺负荷超声心动图在分级心肌缺血中的应用价值

High-dose Dobutamine Stress Echocardiography with Different Degree Myocardial Ischemia

与冠脉造影对照检测临床疑为冠心病患者５５例，评估多巴酚丁胺负荷超声心动图检测冠脉狭窄程度及范围的应用价值。多巴酚丁胺输入中，左室舒张末期容积指数无明显变化；左室收缩末期容积指数于冠脉狭窄小于７４％及冠脉狭窄累及一支组降低，冠脉狭窄大于７４％和冠脉狭窄累及两支以上组增加；检测冠脉狭窄程度及范围的敏感性、特异性及准确度分别为７６％，７８％；８８％，８７％及８３％，８４％；对左前降支狭窄敏感。

Comparing with coronary arterography fifty five patients were detected to assesse the value of high-dose dobutamine stress echocardiography (DSE) in different degree myocardial ischemia. During dobutamine infusion left ventricular end diastolic volume index didn't change significantly in all patients, left ventricular end systolic volume index decresed in one-vessel disease and in patients, whos coronary artery stenosis was less than 74%, but increased in multivessl disease and patients whos coronary artery stenosis was more than 74%. The sensitivity, specificity, and crude agreement of high-dose DSE in assessing the different degree and distribution of coronary artery stenosis were 76%, 78%; 88%, 87%; and 83%, 84%; DSE was most sensitive to the stenosis in the left anterior descending coronary artery.