左心声学造影诊断经皮冠状动脉介入术后冠脉再狭窄的价值

吴美善; 李慧敏; 刘霞; 刘华东; 董少红

doi:10.12125/j.chj.201904057

左心声学造影诊断经皮冠状动脉介入术后冠脉再狭窄的价值

Value of left ventricular contrast echocardiography in diagnosis of coronary restenosis after percutaneous coronary intervention

摘要

摘要:
目的评价冠心病患者经皮冠状动脉介入（percutaneous coronary intervention，PCI）治疗术后随访中运用左心声学造影诊断冠脉再狭窄的价值。
方法选择我院2017年7月至2018年10月纳入的105例冠心病患者作为研究对象，均在我院实施PCI术后，随访中选择左心声学造影检查，同期还做二维超声心动图和实时三维超声心动图作为检测方法的对照，计算和比较相应的评价真实性的指标（灵敏度、特异度和准确度）进行定量评价。
结果左心声学造影诊断PCI术后冠脉再狭窄的灵敏度显著高于二维超声心动图（78% vs 43%，P < 0.05），虽也高于实时三维超声心动图，但差异未达到显著水平(78% vs 70%)；左心声学造影诊断冠脉再狭窄的特异度显著高于二维超声心动图（98% vs 90%，P < 0.05）和实时三维超声心动图（98% vs 85%，P < 0.01），但二维超声心动图的特异度与实时三维超声心动图差异无统计学意义；左心声学造影的准确度显著高于二维超声心动图和实时三维超声心动图（93% vs 80%，82%，均P < 0.01），但二维超声心动图和实时三维超声心动图的准确度差异无统计学意义。
结论左心声学造影用于诊断冠心病PCI术后再狭窄，可显著提升诊断的灵敏度、特异度和准确度。

Abstract:
AIM To evaluate the value of left ventricular contrast echocardiography in the diagnosis of coronary restenosis after percutaneous coronary intervention (PCI) in patients with coronary heart disease. .
METHODS 105 patients with coronary heart disease admitted to our hospital from July 2017 to October 2018 were selected as the study subjects. After PCI, left ventricular contrast echocardiography was selected for follow-up and the results were observed. At the same time, two-dimensional echocardiography and real-time three-dimensional echocardiography were compared as the detection methods, and the corresponding evaluation indicators (sensitivity, specificity and accuracy) were calculated and compared for quantitative evaluation.
RESULTS The sensitivity of left ventricular contrast echocardiography in the diagnosis of coronary restenosis after PCI was significantly higher than that of two-dimensional echocardiography (78% vs 43%, P < 0.05), although it was also higher than that of real-time three-dimensional echocardiography, the difference was not significant (78% vs 70%). The specificity of left ventricular contrast echocardiography in diagnosing coronary restenosis was significantly higher than that of two-dimensional echocardiography (98% vs 90%, P < 0.05) and real-time three-dimensional echocardiography (98% vs 85%, P < 0.01), but there was no significant difference between two-dimensional echocardiography and real-time three-dimensional echocardiography. The accuracy of left ventricular contrast echocardiography was significantly higher than that of two-dimensional echocardiography and real-time three-dimensional echocardiography (93% vs 80%, 82%, P < 0.01), but there was no significant difference between two-dimensional echocardiography and real-time three-dimensional echocardiography.
CONCLUSION Left ventricular contrast echocardiography can significantly improve the sensitivity, specificity and accuracy of diagnosis of restenosis after PCI.

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