多巴酚丁胺负荷定量组织追踪技术诊断老年冠心病的临床研究

目的探讨多巴酚丁胺负荷超声心动图(DSE)与定量组织追踪技术(TT)相结合诊断老年冠心病的临床价值。方法 98例疑似冠心病老年患者行DSE+TT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峰值位移(Dpeak),2周内行冠状动脉造影后将所有患者分成冠心病组与正常组,并将两组Dpeak进行比较研究。结果冠心病组在10、20μg·kg-1·min-1这两个负荷剂量时前壁、前间隔、侧壁、后壁Dpeak小于正常组,差异有统计学意义(P<0.05),而两组下壁Dpeak在其他任何负荷剂量时差异均无统计学意义(P>0.05);与冠状动脉造影比较,Dpeak诊断老年人冠心病的敏感度、特异度、准确性分别为82.4%、61.7%、72.4%,Dpeak在多巴酚丁胺40μg·kg-1·min-1负荷剂量时其诊断的敏感度和特异度最高,分别为88.2%、69.5%。结论多巴酚丁胺负荷定量组织追踪成像是一项安全、有效、无创诊断老年冠心病的方法。

Dobutamine stress quantitative tissue tracking technique for detecting elderly coronary artery disease

Objective The aim of this study was to examine the sensitivity, specificity and accuracy of dobutamine stress quantitative tissue tracking technique （DSE＋TT） for detecting coronary artery disease （CAD） in patients with ≥60 years old. Methods The subjects had DSE, and completed coronary angiography （CAG） in two weeks. The peak distance （Dpeak） in different dobutamine stress doses were measured and analysed during systolic period in mid-segments of left ventricle walls in echopac 8.0 workstation. The subjects were divided into CAD group and normal group. Results The Dpeak of the anterior wall, anterior septal wall, lateral wall and posterior wall from the CAD group in 10, 20 μg·kg-1·min-1 dobutamine stress doses were less than those in the normal group with the statistically significant difference. However the Dpeak of the inferior wall in any doses between two groups had no significant difference. Compared with CAG, the sensitivity, specificity and accuracy of Dpeak for detection CAD in the elderly patients were 82.4%,61.7%,72.4%, respectively. At the dobutamine dose of 40 μg·kg-1·min-1, the Dpeak achieved maximum sensitivity and specificity （88.2% 69.5%）. Conclusion The quantitative dobutamine stress tissue tracking technique is a safe, effective and non-invasive technique for detecting CAD in old patients （≥60 years old）.