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目的探讨背向散射技术结合多巴酚丁胺负荷试验(DSE)能否提高对不同部位冠状动脉狭窄的检测率。方法记录32例临床疑诊为冠心病的患者在不同剂量多巴酚丁胺负荷下左室乳头肌水平短轴观的背向散射积分,按冠状动脉造影结果将心肌节段分组,比较各组心肌在各剂量负荷下背向散射积分周期变异(CVIB)值的变化。结果和正常冠状动脉供血心肌节段相比,狭窄冠状动脉供血心肌节段的CVIB值在静息状态和小剂量多巴酚丁胺负荷下无显著差异,但在大剂量负荷下明显降低。以DSECVIB<4.8dB作为检测冠状动脉狭窄的阈值,对于左前降支病变,DSECVIB法可提高敏感性、特异性和准确率;对于左旋支和右冠状动脉病变,DSECVIB法未能提高检测的敏感性,而提高了特异性和准确率。结论背向散射技术与传统DSE联合应用可提高DSE对不同部位冠状动脉狭窄的检测率,尤其对于左前降支的病变。
Objective To investigate whether backscatter combined with dobutamine stress test (DSE) can improve the detection rate of coronary stenosis in different parts. Methods 32 patients with clinically suspected coronary heart disease under different doses of dobutamine load of short axis view of left ventricular backscatter backscatter points, according to coronary angiography results will be divided into groups of myocardial segments, the comparison of each group The change of CVIB value of myocardium under various dose loads. Results Compared with normal coronary artery blood supply myocardial segments, CVIB values of stenotic coronary artery myocardial segments were not significantly different at rest and under low dose dobutamine stress, but significantly lower under high dose loading. With DSECVIB <4.8dB as the threshold for detecting coronary artery stenosis, DSECVIB improves sensitivity, specificity and accuracy for left anterior descending coronary artery disease and DSECVIB fails to improve sensitivity for left circumflex and right coronary artery disease , While increasing specificity and accuracy. Conclusions The combination of backscatter technique and traditional DSE can improve the detection rate of coronary stenosis in different parts of DSE, especially for the lesions of the left anterior descending branch.