多普勒组织声像图与二维超声心动图对冠心病诊断的对比研究

为了解ＤＴ１及２ＤＥ对冠心病室壁节段性运动异常诊断的异同，本文对４７例经临床确诊的冠心病用ＤＴＩ－ＰＷＤ测定其室壁运动频谱，并与正常组及２ＤＥ检查情况进行比较。结果显示冠心病组室壁运动频谱收缩波（Ｓ）明显低平，时相延迟，方向相反或频谱紊乱，易与正常节段鉴别。且冠心病组９７．８７％的病变节段Ｓ波≤５ｃｍ／ｓ，正常组９８．９３％的Ｓ波＞５ｃｍ／ｓ。２ＤＥ对冠心病诊断的漏诊率达１４．８９％，且对２ＤＥ阴性的病变节段其Ｓ波峰值速度亦已降低。表明ＤＴＩ－ＰＷＤ对冠心病诊断有较高的敏感性，且实时、连续地反映室壁运动速度的变化，可作为定量评价冠心病室壁运动状况的指标之一，我们建议Ｓ波峰值速度５ｃｍ／ｓ可作为判断室壁运动速度异常的界限。

A Comparative Study of Doppler Tissue Imaging and Two dimensional Echocardiography on the Diagnosis in Patients with Coronary Artery Disease

The aim of this study is to assess the differences on the diagnosis of coronary artery disease(CAD)by Doppler tissue imaging(DTI)and two dimensional echocardiography(2DE).The myocardial wall velocity profiles were detected by pulsed DTI in 47 confirmed CAD patients and in a control group.The findings of regional wall motion abnormalities were compared with 2DE.Results:The velocity of systolic wave of myocardial wall velocity profile in CAD group was significantly lower than the control group and the systolic waves in ischemic segments were delayed,with its direction opposited or disordered.The values of systolic waves were less than 5cm/s in 97 7% ischemic segments of CAD group but more than 5cm/s in 98 93% segments of normal subjects.85 11% patients were positively diagnosed by 2DE.But the peak velocities of systolic wave were decreased in the segments by 2DE false negative diagnosis.Conclusion:Pulsed DTI is a sensitive method for diagnosis of coronary artey disease and provides series of recordings of myocardial wall velocity in real time.It can be regarded as one of the quantitative methods to assess the regional wall motion abnormalities in coronary artery disease.We suggest the value 5cm/s of systolic wave as the limit for judging myocardial wall velocity abnormality.