【摘要】 目的 :评价腺苷超声心动图负荷试验对冠心病的诊断价值。方法 :55例拟诊和确诊冠心病 (CHD)患者 ,分别静脉注射腺苷 ,剂量为140μg/(kg·min) ,用药时间6min(总剂量0.8mg/kg)。注射过程中观察和记录室壁运动变化、血压、心率及心电图。左室16节段中出现新的或更严重的室壁节段运动异常 (WMA)为阳性。试验后1周内行冠脉造影 ,至少有1条主要冠脉血管狭窄≥50 %。以冠脉造影为金标准 ,计算腺苷负荷试验敏感性和特异性。结果 :注射腺苷后彩超诊断阳性37例 ,冠脉造影阳性34例 ,2项均阳性32例 ,均阴性16例 ,腺苷诊断CHD敏感性94.12 % ,特异性76.19 % ,准确性87.27 % ,腺苷诊断单支、双支和3支血管病变敏感性分别为75 %、85.71 %和92.31 %。腺苷判断病变血管狭窄>75 %敏感性100 %。不良反应发生率80 % ,症状轻微 ,患者均能耐受。结论 :腺苷超声心动图负荷试验诊断冠心病安全可靠更多还原

【Abstract】 Objective:To assess the diagnostic value of adenosine stress echocardiography testing in patients with coronary heart disease(CHD)and to determine the sensitivity,specificity and acurancy by the golden criˉterion of coronary angiopraphy(CAG).Methods:Adenosine stress echocardiography was performed in55susˉpectable and diagnostic CHD patients using infusion dose of140μg/(kg·min)in6min(total dosape0.8mg/kg).Left ventricular wall motion,BP,HR and ECG were recorded during the procedure,positive criterion was defined as the appearance and worsening of wall notion abnormality(WMA).Results:Adenocine stress eˉchocardiography was positive in37cases.CAG was positive in34cases.Adenosine and CAG were positive in32,negative16cases respectively.The total sensitivity of this test was94.12%,the specificity was76.19%and the aceuraey was87.27%.The sensitivity for detection of myocardial ischemia in one,two and three vessel CAD subgroups was75%,85.71%and92.31%respectively.Moreover the sensitivity for detection of vessel stenosis(>75%)was100%.Morbidity of side effects was80%.Side effects due to adenosine infusion were alˉways minimal and well tolerated by the patients.Conclusions:Adenosine stress echocardiography can be safely performed in CHD patients with high sensitivity and specificity.更多还原