| 摘要: |
| 目的:观察冠心病患者常规超声心动图特征性表现,探讨超声心动图对冠心病的诊断价值及诊断要点。方法:2002年1月-2006年12月疑诊冠心病患者276例均行常规超声心动图检查,其中190例行冠脉造影检查,86例仅行常规超声心动图检查。190例联合检查患者中85例为对照研究,分析常规超声心动图与冠脉造影的诊断符合率；另105例根据冠脉造影确诊的狭窄、闭塞程度分析其常规超声心动图异常表现。结果:与冠状造影对照,常规超声心动图诊断符合率为90.6%,假阴性、假阳性率均为4.7%。冠心病患者常规超声心动图表现包括:左室增大(23.2%)、左房增大(16.3%)、左室收缩功能降低(9.3%)、左室舒张功能降低(74.4%)等。冠脉狭窄及梗阻患者常规超声心动图表现包括:左室增大(9.5%)、左室收缩功能降低(8.57%)、左室舒张功能降低(92.3%)、E/A比值下降等,其中血管损伤支数越多E/A比值下降越明显,1、2、3、4支损伤E/A比值依次为0.78、0.66、0.64、0.61,差异具有统计学意义(P<0.05),但无明显规律性。结论:常规超声心动图检查诊断冠心病与冠脉造影诊断符合率高,适合在基层医院推广；左室舒张功能减退是其主要特征性表现,应侧重于相关指标的观察,但必须排除心律失常等因素的干扰。 |
| 关键词: 冠心病 超声心动描记术 冠状动脉造影 |
| DOI：10.3724/SP.J.1008.2009.01035 |
| 投稿时间：2008-03-03修订日期：2009-05-12 |
| 基金项目: |
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| Characteristics and diagnostic value of echocardiography of patients with coronary heart disease |
| CHEN Ning-ning1,YAO Wei1,ZHAO Yu-hua1*,LI Mei2,XI Yan3,LU Feng-ju2,ZHANG Hai-chun3 |
| (1.Department of Ultrasound Diagnosis,Changhai Hospital,Second Military Medical University,Shanghai 200433,China; 2.Department of Ultrasound Diagnosis,Shanghai Jing’an Hospital,Shanghai 200040;3.Department of Ultrasound Diagnosis,Shanghai Quyang Hospital,Shanghai 200092) |
| Abstract: |
| Objective:To observe the echocardiography characteristics of patients with coronary heart disease (CHD),and to discuss the diagnostic value of their echocardiography for CHD.Methods:From Jan.2002 to Dec.2006, a total of 276 patients with suspected CHD were examined by echocardiography; 190 patients also underwent coronary arteriography (CA) and 85 of them served as controls.The consistence between echocardiography results and CA results was analyzed.The abnormal echocardiography manifestations of the rest 105 patients were analyzed based on the stenoses and occlusion degrees revealed by CA.Results:The diagnostic consistent rate of routine echocardiographic examination was 90.6% compared with that of CA.The false positive and negative rates were both 4.7%.The echocardiographic features of CHD included the reduction of left ventricular diastolic function (74.4%),the left ventricle enlargement (23.2%),the left atrium enlargement (16.3%),and the reduction of left ventricular systolic function (9.3%).The echocardiographic features of coronary artery stenosis and occlusion included the reduction of left ventricular diastolic function (92.3%),the left ventricle enlargement (9.5%),the reduction of left ventricular systolic function (8.57%),and the reduction of E/A ratio.More diseased branches was associated with lower E/A ratio.The E/A ratios of patients with 1,2,3 and 4 diseased branches were 0.78,0.66,0.64 and 0.61,respectively; the difference of E/A ratios of different groups was significantly different (P<0.05).Conclusion:Routine echocardiographic examination has a high consistent rate with CA in diagnosis of CHD,and it is suitable for popularizing in grass-root hospitals.Reduction of left ventricular diastolic function is the main echocardiographic feature of CHD,and more attention should be paid on related parameters,but the influence of arrhythmia and other factors should be ruled out. |
| Key words: coronary heart disease echocardiography coronary arteriography |
