腺苷负荷心肌组织应变率显像对冠心病诊断的研究

The Study of the Diagnostic Value of Strain Rate Imaging(SRI) Combined with Adenosine Stress for Coronary Artery Disease

目的探讨心肌组织应变率显像技术(SRI)结合腺苷负荷超声心动图试验(ASE)对冠心病(CAD)的诊断价值。方法随机抽取临床拟诊冠心病患者45例,持续匀速静脉注射腺苷140μg/(kg·min)共6min,分别于试验即时、给药3min、6min、及终止给药后5min(即试验11min)时,完成左室壁16节段的彩色组织多普勒显像,储存图像,应用QLAB软件中SQ技术分析各节段的收缩期最大速度、收缩期最大应变、收缩期最大应变率变化规律,并与冠状动脉造影结果进行比较。结果应用腺苷3min、6min时,以冠状动脉狭窄部位相对应的节段的收缩期最大速度、收缩期最大应变、收缩期最大应变率均降低作为诊断冠心病的阳性标准。该方法诊断冠心病的敏感性为77.27%,特异性为89.47%,无明显不良反应。结论心肌组织应变率显像技术(SRI)结合腺苷负荷超声心动图试验(ASE)诊断冠心病的方法是可行的。

Objective To investigate the diagnostic value of strain rate imaging （SRI） combined with adenosine stress echocardiography for coronary artery disease （CAD）. Methods In 45 cases of suspected coronary artery diseases,who were given the adenosine 140 μg/（ kg · min）intravenously for 6 minutes continuously, the SRI of 16 left ventricular segments was acquired in before test and 3 minutes and 6 minutes from the injection,and 5 minutes after injection respectively. Analyzing the change of the myocardial systolic strain rate, strain and velocity,and comparing them with the coronary angiography. Results by the reduction of the myocardial systolic strain rate, strain and velocity in order to diagnose the coronary artery disease. The sensitivity was 77. 27% and specificity was 89.47%, without serious adverse reactions. Conclusion The method of myocardial strain rate imaging （SRI） combined with adenosine stress echocardiography test for the diagnosis of the coronary heart disease is feasible.