摘要
经食管超声（ＴＥＥ）＋潘生丁（ｄｉｐｙｒｉｄａｍｏｌｅ）药物试验测定冠状动脉的血流速度，并根据冠状动脉最大扩张时的血流速度／基础状态下的血流速度之比值来计算冠状动脉储备功能（ＣＦＲ）的指数。我们先后对４４例胸痛待查的患者进行了冠状动脉造影和ＴＥＥ＋潘生丁药物试验，３８例（８６％）的病人获得了满意的ＴＥＥ图像。根据冠状动脉造影的结果将３５例患者分为二组：Ａ组１７例为左前降支狭窄≥５０％或（和）左回旋支狭窄者；Ｂ组２１例为左冠状动脉病变０～＜５０％者。经ＴＥＥ多普勒测定潘生丁注射前、后的左前降支舒张期血流速度，Ａ组的ＣＦＲ指数——峰值舒张期血流速度比值（Ｄ／ＢＰＤＶ）和平均舒张期血流速度比值（Ｄ／ＢＭＤＶ）均明显低于Ｂ组（Ｐ＜０．００１）。如以ＣＦＲ指数２．０作为判断严重冠状动脉病变（≥７５％）的临界点，则其敏感性为８２．４％，特异性为８５．７％，准确性为８４．２％，即提示：通过ＣＦＲ的测定可以从血流动力学的角度来评价冠状动脉病变的程度。
Objectives: To determine the feasibility of estimating coronary stenosis by coronary flow reserve (CFR) measurd with transesophageal Doppler echocardiography (TEE) and the accuracy of assessing coronary stenosis by CFR. Methods : Forty four patients who had recently undergone coronary angiography had been measured the diastolic velocity in the proximal left anterior descending coronary artery by TEE Doppler before and after dipyridamole injection (0.7mg/kg). CFR index was calculated by the ratio of post dipyridamole maximum to baseline diastolic flow velocity. Satisfactory TEE recording was obtained in 38 of the 44 (86%) patients. 17 of the 38 patients had significant coronary (LAD) stenosis (group A), while the remainders had no significant stenosis (group B). Results: The CFR ratio for peak and mean diastolic velocity of group B was siginificantly higher than that of group A ( P <0 001). A CFR ratio≥2 0 had a sensitivity of 82.4%, a specificity of 85.7% and overall accuracy of 84.2% for predicting the absence of critical LAD stenosis (≥75%). Conclusion:CFR assessed by TEE Doppler is useful for dynamically estimating coronary stenosis.
出处
《中华心血管病杂志》
CSCD
北大核心
1997年第5期349-352,共4页
Chinese Journal of Cardiology
