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目的 :评价多巴酚丁胺负荷超声心动图 (DSE)诊断经皮穿刺冠状动脉腔内成形术 (PTCA)后冠状动脉再狭窄的临床价值。方法 :选择 5 0例行PTCA术冠心病患者 ,于PTCA术后 6个月行DSE ,观察试验前后室壁运动 ,并检测和计算左室舒张末期容积指数 (LVEDVI)、左室收缩末期容积指数 (LVESVI)、左室射血分数(LVEF)。室壁运动不变或降低诊断为再狭窄。 1周后行冠状动脉造影 (CAG) ,根据CAG结果分为再狭窄组和非再狭窄组 ,比较两组DSE前后血流动力学变化。结果 :DSE检测冠状动脉再狭窄的敏感性为 81.3% ,特异性为 85 .2 % ,准确性为 84 %。与静息比较 ,再狭窄组LVESVI和LVEDVI明显升高 ,LVEF明显降低 (P <0 .0 5 ) ;与非再狭窄组比较 ,DSE后LVESVI明显升高 ,LVEF明显降低 (P <0 .0 1)。结论 :PTCA术后再狭窄患者DSE试验后心功能明显下降 ,DSE是一种较理想的简便易行诊断PTCA术后再狭窄的方法
Objective: To evaluate the clinical value of dobutamine stress echocardiography (DSE) in the diagnosis of coronary artery restenosis after percutaneous transluminal coronary angioplasty (PTCA). Methods: Fifty patients with coronary artery disease undergoing PTCA were enrolled. DSE was performed 6 months after PTCA. The ventricular wall motion was observed before and after the operation. The left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), left ventricular ejection fraction (LVEF). Wall motion unchanged or reduced to the diagnosis of restenosis. One week later, coronary angiography (CAG) was performed and divided into restenosis group and non-restenosis group according to the result of CAG. The hemodynamic changes before and after DSE were compared between two groups. Results: The sensitivity and specificity of DSE in detecting coronary artery restenosis were 81.3%, 85.2% and 84% respectively. Compared with resting group, LVESVI and LVEDVI in restenosis group were significantly increased and LVEF was significantly decreased (P <0.05); LVESVI was significantly increased and LVEF was significantly decreased in DSS group compared with non-restenosis group (P <0. 0 1). Conclusion: The cardiac function of patients with restenosis after PTCA is obviously decreased after DSE. DSE is an ideal method to diagnose the restenosis after PTCA