多巴酚丁胺和潘生丁负荷试验对冠心病诊断价值的比较

Comparison of dobutamine and dipyridamole stressing test in the diagnosis of coronary artery disease

目的比较多巴酚丁胺和潘生丁负荷心肌显像对冠心病的诊断价值及对心肌梗塞后残余心肌缺血的检出率。方法与结果对１１０例冠心病患者进行药物介入９９ｍＴｃ－ＭＩＢＩ心肌显像，其中多巴酚丁胺心肌显像５２例，潘生丁心肌显像５８例，诊断冠心病的敏感性、特异性、阳性预测值和诊断准确率分别为９２３％对８７９％、９４１５％对８９５％、９６０５％对９２７％和９３０％对８８５％，差异无显著性。对心肌梗塞后残余心肌缺血的检出率（７／９对９／１２），亦无明显差异。研究过程中未发现严重副作用。结论多巴酚丁胺和潘生丁负荷心肌显像对冠心病诊断均具有较高的敏感性和特异性，二者对于心肌梗塞后残余心肌缺血检出率也相似，同时也是安全的，可以代替运动试验。

Objective To detect the value of dobutamine and dipyridamole stressing test in the diagnosis of coronary artery disease (CAD) and residual ischemia after myocardial infarctionMethodsOne hundred and ten patients with CAD underwent pharmcologic stress99m Tc-MIBI myocardial imaging,including 52 with dobutamine (Dobu-ECT) and dipyridamole (Dipy-ECT) tests.The sensitivity specificity,positive predictivity and accuracy for detecting CAD of be Dobu-ECT and Dipy-ECT was 923% vs 879%,941% vs 895%,960% vs 927%,and 930% vs 885% respectively,and there was no difference between them.It identify the residual ischemia after myocardial infarction was also similar (7/9 vs 9/12)No serious side effects were found in the two studiesConclusionBoth Dobu-ECT and Dipy-ECT are safe methods with high sensitivity and specificity for detecting CAD and identifying the residual ischemia after myocardial infarctionThey can instead of exercise test