多巴酚丁胺负荷组织多普勒诊断老年冠心病的临床价值

Dobutamine quantitative stress tissue doppler imaging for diagnosing coronary artery disease in the elderly

目的探讨多巴酚丁胺负荷超声心动图（DSE）与定量组织多普勒技术（TDI）相结合诊断老年冠心病的临床价值。方法98例老年患者行DSE与TDI相结合检查，测定不同多巴酚丁胺负荷剂量时各室壁中段收缩期心肌运动峰值速度（Vpeak）、收缩期心肌峰值位移（Dpeak）、收缩期峰值应变率（SRpeak）、收缩期峰值应变（Speak），2周内完成冠状动脉造影。结果和冠状动脉造影相比，Vpeak、Dpeak、SRpeak、Speak诊断老年人冠心病的敏感性、特异性、精确性分别为Vpeak82．4％、61．7％、72．4％，Dpeak82．4％、59．5Voo、71．4％，SRpeak71．7％、82．2％、78％，Speak78．6％、72．3％、74．7％。DSE＋TDI不良反应轻。结论DSE与TDI是一项安全、有效、无创诊断老年冠心病的方法，具有较高的敏感性和特异性。

Objective To examine the sensitivity, specificity and accuracy of dobutamine stress quantitative tissue doppler imaging（DSE--TDD for detecting CAD in the elderly patients. Methods Totally 98 patients underwent DSE＋ TDI, and completed coronary angiography （CAG） in two weeks. Peak tissue velocity （Vpeak）, peak tissue tracking （Dpeak）, peak strain rating （SRpeak）, peak strain （Speak）in different dobutamine stress stations were measured and analyzed during systolic period in mid segments of left ventricle walls. Results In comparison of CAG, the sensitivity, specificity and accuracy of DSE＋ TDI for detection CAD in the elderly patients showed that Vpeaks were 82.3%, 61.7%,72.4%, Dpeak 82.4%, 59.5%,77.4%, SRpeak 71.7%, 82.2%,78% and Speak 78.6%, 72.3%, 74.7%, respectively. All the adverse effects during tests were mild and transient. Conclusions Quantitative dohutamine stress tissue doppler imaging is a safe, effective and non-invasive technique and has higher sensitivity and specificity for detecting CAD in the elderly patients.