舌下含化硝酸甘油超声心动图试验检测存活心肌的研究

Detection of viable myocardium by sublingual nitroglycerin echocardiography

目的 评价舌下含化硝酸甘油超声心动图试验检测存活心肌的临床价值。方法 45例心肌梗死后患者接受经皮腔内冠状动脉成形术 (PTCA)前进行舌下含化硝酸甘油超声心动图(NE)及小剂量多巴酚丁胺 硝酸甘油超声心动图 (DNE)试验 ,PTCA后随访 9个月 ,将NE及DNE识别为存活心肌的室壁节段与实际运动改善节段做比较 ,判定其检测存活心肌的准确性。结果 NE检测存活心肌特异性高 ,与DNE比较差异无显著性 (85 .5 %vs 81.1% ,P >0 .0 5 ) ,但敏感性低于DNE(44 .9%vs 80 .4% ,P <0 .0 5 )。结论 NE试验检测存活心肌敏感性不高 ,但其特异性高 ,且简便易行 。

Objective To evaluate the clinical values of nitroglycerin echocardiography for detecting viable myocardium. Methods Forty five patients with myocardial infarction underwent sublingual nitroglycerin echocardiography (NE) and low dose dobutamine nitroglycerin echocardiography (DNE) test before PTCA. The patients were followed up for 9 months. The viable segments identified by NE and DNE tests and the corresponding real improved segments were compared to verdict the accuracy of the tests for detecting viable myocardium. Results NE was high specific for detecting viable myocardium and not different from that of DNE (85.5% vs 81.1%, P>0.05), but the sensitivity of NE was lower than that of DNE (44.9% vs 80.4%, P<0.05). Conclusion NE test is not quite sensitive for detecting viable myocardium, but the test has high specificity, no side effect, and the procedure is quite simple. So, NE test is practicable to a certain extent. [