【摘要】 目的:探讨经胸超声心动(TTE)在急性主动脉夹层(AAD)尤其是Stanford A型AAD诊断中的应用价值。方法:回顾本院近3年诊治的66例AAD患者的临床资料,分析总结其超声表现。采用的TTE分析指标包括:主动脉增宽、主动脉瓣反流、主动脉内膜漂浮和/或主动脉壁内血肿、心包积液/填塞,计算其诊断的敏感性和特异性。结果:本研究中4个指标诊断A型AAD的敏感性分别为66.67%、52.08%、43.75%和35.42%,特异性分别为83.33%、61.11%、94.44%、94.44%;诊断B型AAD的敏感性分别为16.67%、38.89%、5.56%、5.56%,特异性分别为66.67%、52.08%、43.75%、35.42%。其中46例(95.83%)A型AAD患者具有上述一项或以上超声特征,诊断特异性为44.44%。结论:TTE对于Stanford A型AAD的诊断敏感性高,是诊断近端主动脉夹层的可靠方法,可作为AAD(尤其是血流动力学不稳定AAD)诊断和评估的一个有效辅助手段。更多还原

【Abstract】 Objective:To explore the value of transthoracic echocardiography(TTE)in diagnosis of acute aortic dissection(AAD),especially in type A.Methods:The retrospective analysis included 66 patients with AAD referred to our hospital between January 2013 and December 2015.The signs of TTE were analyzed and their sensitivity and specificity were calculated.Results:Four TTE characteristics were analyzed,including ascending aorta dilation,aortic valve insufficiency,the presence of intimal flap/aortic intramural hematoma and pericardial effusion/cardiac tamponade.The sensitivity of the four TTE features to diagnose type A AAD was 66.67%,52.08%,43.75% and 35.42% respectively;the specificity was 83.33%,61.11%,94.44% and 94.44% respectively.The sensitivity of to diagnose type B AAD was 16.67%,38.89%,5.56% and 5.56% respectively,and the specificity was 66.67%,52.08%,43.75% and 35.42% respectively.Detection of one or more TTE signs of type A AAD had a sensitivity of 95.83%,specificity of 44.44%.Conclusion:TTE is a sensitive method in diagnosis of acute type A aortic dissection.It can be a reliable method for the diagnosis and treatment of AAD,especially when the hemodynamic was unstable.更多还原