摘要
目的:探讨经胸超声心动(TTE)在急性主动脉夹层(AAD)尤其是Stanford A型AAD诊断中的应用价值。方法:回顾本院近3年诊治的66例AAD患者的临床资料,分析总结其超声表现。采用的TTE分析指标包括:主动脉增宽、主动脉瓣反流、主动脉内膜漂浮和/或主动脉壁内血肿、心包积液/填塞,计算其诊断的敏感性和特异性。结果:本研究中4个指标诊断A型AAD的敏感性分别为66.67%、52.08%、43.75%和35.42%,特异性分别为83.33%、61.11%、94.44%、94.44%;诊断B型AAD的敏感性分别为16.67%、38.89%、5.56%、5.56%,特异性分别为66.67%、52.08%、43.75%、35.42%。其中46例(95.83%)A型AAD患者具有上述一项或以上超声特征,诊断特异性为44.44%。结论:TTE对于Stanford A型AAD的诊断敏感性高,是诊断近端主动脉夹层的可靠方法,可作为AAD(尤其是血流动力学不稳定AAD)诊断和评估的一个有效辅助手段。
Objective：To explore the value of transthoracic echocardiography（TTE）in diagnosis of acute aortic dissection（AAD）,especially in type A.Methods：The retrospective analysis included 66 patients with AAD referred to our hospital between January 2013 and December 2015.The signs of TTE were analyzed and their sensitivity and specificity were calculated.Results：Four TTE characteristics were analyzed,including ascending aorta dilation,aortic valve insufficiency,the presence of intimal flap/aortic intramural hematoma and pericardial effusion/cardiac tamponade.The sensitivity of the four TTE features to diagnose type A AAD was 66.67%,52.08%,43.75% and 35.42% respectively;the specificity was 83.33%,61.11%,94.44% and 94.44% respectively.The sensitivity of to diagnose type B AAD was 16.67%,38.89%,5.56% and 5.56% respectively,and the specificity was 66.67%,52.08%,43.75% and 35.42% respectively.Detection of one or more TTE signs of type A AAD had a sensitivity of 95.83%,specificity of 44.44%.Conclusion：TTE is a sensitive method in diagnosis of acute type A aortic dissection.It can be a reliable method for the diagnosis and treatment of AAD,especially when the hemodynamic was unstable.
出处
《中日友好医院学报》
2016年第3期131-133,F0002,共4页
Journal of China-Japan Friendship Hospital
基金
首都特色专项基金(2015-BKJ-003)
