经胸超声冠状动脉血流显像评价左前降支狭窄的价值

The evaluation of transthoracic doppler echocardiography in left anterior descending coronary artery stenosis

目的应用经胸超声冠状动脉血流显像技术(TTDE)评价冠状动脉左前降支(LAD)全程显著狭窄(≥70%)。方法90例患者于冠状动脉造影(CAG)前用TTDE测量LAD各项血流指标,对比CAG分析结果。结果56段血管狭窄≥70%(狭窄组),121段血管无狭窄(对照组),两组比较,近、中段指标均存在差异,远段Vd/Vs、MVd/MVs,P<0.05。Vd/Vs、MVd/MVs≤1.7时,评价LAD显著狭窄的敏感度、特异度处于最佳点。结论应用TTDE检测LAD狭窄,无创、实用,具有临床价值。

Objective To evaluate the significant stenosis （ ≥70% ） of proximal, middle and distal segments in left anterior descending coronary artery （LAD） by using transthoracic Doppler echocardiography （TTDE）. Methods 90 patients who were scheduled for coronary angiography （CAG） were prospectively measured and calculated the parameters - flow velocity, diastolic - to - systolic flow velocity ratio （ Vd/Vs ） and mean diastolic - to - systolic flow velocity ratio （ MVd/MVs ） of the entire LAD by TTDE, and then analyse the results of CAG. Results There were 56 stenosis segments in stenosis group （ ≥70% ） and 121 normal segments in contrast group. The parameters which were different from the two groups in proximal and middle segments, had no difference except for Vd/Vds and MVd/MVs （ P 〈 0.05 ） in distal segment. It was the best point for the higher sensitivity and specificity to evaluate significant stenosis of the entire LAD When Vd/Vs, MVd/MVs ≤ 1.7. Conclusion It is a noninvasive and valuable method by using TTDE to evaluate the stenosis of LAD.