腘动脉血流频谱改变对下肢动脉近心段重度狭窄的诊断价值

Diagnostic value of the changes in popliteal artery blood flow spectrum for severe proximal stenosis of heart

目的探讨腘动脉血流频谱改变对下肢动脉近心段重度狭窄的诊断价值。方法经CTA或DSA诊断证实的106条髂腘段动脉重度狭窄下肢动脉为研究组,154条髂腘段动脉无重度狭窄下肢动脉为对照组,将腘动脉血流频谱与CTA或DSA检查结果对比,分析以腘动脉频谱呈"小慢波"波形、收缩期流速<35 cm/s和收缩期加速时间>0.11 s诊断近心段重度狭窄的敏感性、特异性、准确性、阳性预测值、阴性预测值。结果与对照组比较,1研究组腘动脉小慢波出现率增高,流速降低,加速时间延长,差异均有统计学意义(P<0.05)。2分别以腘动脉频谱呈"小慢波"波形、收缩期流速<35 cm/s、收缩期加速时间>0.11 s以及三者联合,诊断下肢动脉近心段重度狭窄的敏感性、特异性、准确性、阳性预测值、阴性预测值分别为:95.41%、98.68%、97.31%、98.11%、96.75%;92.98%、100%、95.38%、100%、94.81%;91.38%、100%、96.15%、100%、93.51%;98.11%、98.70%、98.46%、98.11%、98.70%。结论腘动脉远段"小慢波"波形和流速<35 cm/s及加速时间>0.11 s对下肢动脉近心段重度狭窄均有较高的诊断价值,综合考虑可提高诊断准确性。

Objective To investigate the diagnostic value of the changes in popliteal artery blood flow spectrum for severe proximal stenosis of heart .Methods One hundred and six iliac popliteal arteries with severe stenosis that had been confirmed by CT angiography（CTA）and digital subtraction angiography （DSA）were selected as research group while 154 without stenosis were used as control group.The popliteal artery blood flow spectrum were compared with the results of CTA and DSA to analyze the sensitivity ,speci-ficity,accuracy,positive predictive value and negative predictive value of severe proximal stenosis of heart by using indexes such as＂tardus-parvus waveform＂ of the popliteal artery spectrum ,systolic velocity ＜35 cm/s and systolic acceleration time ＞0.11 s.Results①The incidence of ＂tardus-parvus waveform＂ in the research group was significantly higher than that in the control group （ P ＜0.05 ） .The blood flow rate was decreased and acceleration time was delayed in the research group when compared to the control group （all P ＜0.05）.②The sensitivity,specificity,accuracy,positive predictive and negative predictive values of the ＂tardus-parvus wave-form＂ were 95.41%,98.68%,97.31%,98.11%and 96.75%,respectively .The diagnostic parameters for systolic velocity ＜35 cm/s were 92.98%,100%,95.38%,100% and 94.81%, respectively while systolic acceleration time ＞0.11 s were 91.38%,100%, 96.15%,100%and 93.51%,respectively.These diagnostic parameters were 98.11%,98.70%,98.46%,98.11%and 98.70%,re-spectively if the three indexes were combined .Conclusion The ＂tardus-parvus waveform＂, velocity ＜35 cm/s and the acceleration time ＞0.11 s of popliteal artery blood flow spectrum all have high diagnostic value for severe proximal stenosis of heart .The accuracy may be increased if the three indexes are combined .