摘要
目的应用二维斑点追踪成像技术(2D-STI)分析冠状动脉慢血流(CSF)患者左室整体心肌功能的变化,探讨左室心肌整体收缩及舒张做功效能(MSP/MDP)在CSF患者早期诊断中的价值。方法选取2018-01-05-2019-12-21沈阳医学院附属第二医院心内科收治的冠状动脉造影显示左前降支(LAD)慢血流的患者77例作为CSF组,另选同期冠状动脉造影结果正常患者30例作为对照组,测量两组患者常规超声心动图指标,左室纵向、径向及圆周方向收缩期应变与舒张期应变率,计算MSP与MDP,比较两组间的差异;绘制MSP和MDP的ROC曲线,对其早期诊断CSF的价值进行判断,并计算Kappa值评价诊断结果与冠状动脉造影结果的一致性。结果两组常规超声心动图指标比较显示,CSF组E峰及E/A明显低于对照组(P<0.05),EDV、ESV、LVEF、SV、A峰、e’、E/e’等指标差异无统计学意义,均P>0.05。两组2D-STI指标比较显示,CSF组GLS、GLSRe、GCS、GCSR、GRS、GRSR、MSP及MDP均明显低于对照组(P<0.05),尤其是MSP和MDP的减低程度最大。此时MSP灵敏度为88.3%,特异度为78.0%;MDP灵敏度为73.8%,特异度为86.0%,两者之间的灵敏度和特异度比较差异均无统计学意义,P>0.05;MSP和MDP的Kappa值分别为0.663和0.604,与冠状动脉造影结果一致,但MSP相对优于MDP。结论MSP及MDP可早期识别出CSF患者心肌整体收缩及舒张功能的异常,尤其是MSP具有一定的临床诊断应用前景。
Objective To discuss the value of left ventricular myocardial systolic and diastolic performance(MSP/MDP)in early diagnosis of patients with CSF by assessing the changes of left ventricular myocardial function in patients with coronary artery slow flow(CSF).Methods From January 5,2018 to December 21,2019,77 patients with CSF in the left anterior descending artery(LAD)were selected as the CSF group,and 30 patients with normal coronary angiography results were involved as the control group.Measure the conventional echocardiographic indicators,the systolic strain and the diastolic strain rate of the left ventricular in longitudinal,radial,and circumferential,calculate MSP and MDP,compare the differences between the two groups,and judged the diagnostic value of MSP and MDP in early diagnosis of CSF by ROC curve,and calculate the Kappa value to evaluate the degree of consistency between the diagnosis results and the coronary angiography results.Results The comparison of conventional echocardiographic indicators between the two groups showed that the E peak and E/A in CSF group were significantly lower than control group(P<0.05),and there was no significant difference in EDV,ESV,LVEF,SV,A peak,e’and E/e’(all P>0.05);the comparison of 2 D-STI indicators between the two groups showed that GLS,GLSRe,GCS,GCSR,GRS,GRSR,MSP and MDP were all significantly lower in CSF group than control group(all P<0.05),in particular,MSP and MDP decreased mostly.At this time,the sensitivity of MSP was 88.3%and the specificity was 78.0%;the sensitivity of MDP was 73.8%and the specificity was 86.0%,the difference in sensitivity and specificity between them had no statistically significant(P>0.05).The Kappa value of MSP and MDP were 0.663 and 0.604,which had a moderate degree of consistency with the coronary angiography results,but MSP was better than MDP relatively.Conclusion MSP and MDP can identify the abnormity of left ventricular systolic and diastolic function in patients with CSF in the early stage,especially MSP has a certain application prospect of clinical diagnosis.
作者
姜薇
刘洁
王慧
于淼
李潞
JIANG Wei;LIU Jie;WANG Hui;YU Miao;LI Lu(Department of Ultrasonography,Second Hospital of Shenyang Medical College,Shenyang 110002,China)
出处
《社区医学杂志》
CAS
2021年第6期360-364,共5页
Journal Of Community Medicine
基金
辽宁省科学技术计划项目(2018225015)
关键词
冠状动脉慢血流
左室
心肌功能
二维斑点追踪技术
coronary slow flow
left ventricular
myocardial function
two-dimensional speckle tracking imaging
