经胸和经食管超声对老年主动脉瓣退行性变早期诊断的研究

The diagnostic value of transthoracic and transesophageal echocardiography in early stage of senile degenerative aortic valvular disease

目的 评价和对比经胸 (TTE)和经食管 (TEE)超声心动图诊断老年人主动脉瓣周钙化的价值。方法 通过TTE和TEE超声对 5 0例老年主动脉瓣退行性变患者进行检查 ,并以自身前后对照 ,每位入选对象先后行TTE、TEE检查和螺旋CT检查各 1次。结果 螺旋CT示主动脉瓣周钙化阳性的 19例 ,阴性的 31例。以螺旋CT检查结果为对照 ,TTE的敏感性为 6 3% ,特异性为 71% ,准确性为 6 8% ;TEE的敏感性为 79% ,特异性为 6 5 % ,准确性为 70 % ;联合检查的敏感性为 84 % ,特异性为 5 8% ,准确性为 6 8%。结论 TEE超声诊断早期老年性主动脉瓣周钙化的敏感性显著高于TTE ,特异性和准确性接近 ;联合应用TTE和TEE可进一步提高敏感性。

Objective To evaluate the value of transthoracic (TTE) and transesophageal echocardiography (TEE) in detecting the calcification of early senile degenerative aortic valve.Methods Fifty patients with senile degenerative aortic valvular disease were examinated by TTE and TEE.The study used self-control. Each subject received TTE, TEE and spiral CT.Results There was significant difference between TTE and TEE in detecting the calcification at the base of aortic valve leaflet(P<0.001).The sensitivity of TTE was 63%,specificity was 71% and accuracy was 68%. The sensitivity, specificity and accuracy of TEE were 79%, 65% and 70% respectively.The sensitivity of examination by combining TTE with TEE was 84%, the specificity was 58% and the accuracy was 68%.Conclusions The sensitivity of TEE was higher than that of TTE in the diagnosis of early senile degenerative valvular disease.Combination of TTE and TEE could improve further the sensitivity.