摘要
以冠状动脉造影为标准，对４３例冠脉狭窄大于或等于５０％的冠心病患者及１７例冠脉狭窄小于５０％或腔径正常的临床可疑冠心病患者作为“正常”对照，用心得安食管心房调搏超声心动图（ＴＲＡＳ－Ｐｒｏｐ－Ｅｃｈｏ），食管心房调搏超声心动图（ＴＲＡＳ－Ｅｃｈｏ）和心得安食管心房调搏心电图（ＴＲＡＳ－Ｐｒｏｐ－ＥＣＧ）试验对冠心病的诊断价值进行评价。发现ＴＲＡＳ－Ｐｒｏｐ－Ｅｃｈｏ的敏感性为９３％，特异性为９４．１％，准确性为９７．６％；而ＴＲＡＳ－Ｅｃｈｏ及ＴＲＡＳ－Ｐｒｏｐ－ＥＣＧ的敏感性、特异性、准确性分别为９３．０％及８３．７％，７６．５％及７６．０％，９０．９％及９０．０％。试验中未发现严重不良反应发生。结果显示ＴＲＡＳ－Ｐｒｏｐ－Ｅｃｈｏ试验是安全、准确性较好的无创性冠心病诊断试验，尤适用于年老体衰、肥胖及有生理缺陷不宜运动者。
the coronary artery angiography was used as the diagnostic standard of coronary artery disease(CAD). There were 43 patients of CAD(whose coronary artery was narrowed more than 50%) in first group. The 17 patients of clinical supposed CAD(whose coronary artery was narrowed less than 50% or whose luminal diameter was normal) were as second group “normal control”. the combined test of propanolol and transesophageal atrial stimulation with echocardiography(TRASPropEcho),the combined test of transesophageal atrial stimulation with echocardiography(TRASEcho),and the combined test of propanolol and transesophageal atrial stimulation with electrocardiography(TRASPropECG) are performed to assess the diagnostic value of CAD. We conclude that the sensitivity of TRASPropEcho is 93%,the specificity 94.1%,the accuracy 97.6%,while the sensitivity of TRASEcho is 93%,the specificity 76.5%,the accuracy 90.9%,and the sensitivity of TRAS-PropECG is 83.7%,the specificity 76%,the accuracy 90%. NO serious side effects were of happen. The result showed that TRASPropEcho test is a safe,accurate and noninvasive diagnostic method of CAD. Further,the method is better used for the senior, the obese people and the patients who are intolerant of exercise.
关键词
冠心病
超声心动图
心房调搏法
心得安
诊断
coronary disease echocardiography propranolol transesophageal atrial stimulation
