摘要
目的探究联合应用缺血修饰白蛋白(IMA)与二维斑点追踪技术(2D-STI)早期诊断不稳定型心绞痛(UA)的临床意义。方法根据冠脉造影结果选取山西医科大学第一医院心内科2014年9月至2016年9月收治的118例左前降支单一病变且狭窄程度≥70%并行经皮冠状动脉介入治疗(PCI)治疗的UA患者(PCI组)以及78例冠脉无狭窄的患者(对照组),两组术中记录胸痛症状及常规12导联心电图,分别于术前及术后检测IMA、行超声心动图检查。应用2D-STI技术计算左室整体纵向应变(GPLS)。数据采用SPSS 19.0统计学软件进行分析处理。结果PCI组术前IMA、GPLS与对照组术前比较差异无统计学意义(P>0.05);PCI组术后IMA、GPLS与对照组术前比较差异无统计学意义(P<0.05);PCI组术前术后IMA、GPLS差异有统计学意义(P<0.05);对照组术前术后IMA、GPLS差异无统计学意义(P>0.05)。IMA、GPLS(2D-STI)单项检测PCI组术后心肌缺血的敏感度分别为85.22%、66.96%,特异度分别为65.38%、74.36%;IMA联合GPLS(2D-STI)检测PCI组术后心肌缺血的敏感度为64.35%,特异度为93.59%;联合检测特异度明显高于单项检测,差异有统计学意义(P<0.05)。结论 IMA联合2D-STI有利于UA的早期诊断,可为临床UA诊断提供参考依据。
Objective To explore the clinical significance of combined application of IMA with two-dimensional speckle tracking imaging （2D-STI） in the early diagnosis of unstable angina pectoris. Methods According to the results of coronary angiography, 118 patients, who had single lesion of left anterior descending artery, stenosis greater than 70% and were treated with PCI, were selected as the experimental group ; 78 patients who had not coronary artery stenosis were as the control group. Two groups were recorded chest pain symptoms and 12 lead ECG during operation, and were detected IMA and echocardiography in the preoperative and postoperative period respectively. Use 2D-STI technique to calculate the global peak longitudinal strain （GPLS）. Statistical analysis was performed using SPSS 19.0 software. Results There was no difference on preoperative IMA or GPLS between group PCI and control group（P〉 0.05）. There was difference on preoperative IMA, GPLS group PCI and control group（P 〈 0.05）. In group PCI, preoperative and postoperative IMA and GPLS had significant difference （P 〈 0.05）. In control group, preoperative and postoperative IMA and GPLS had no difference （P 〉 0.05）. The sensitivity oflMA and GPLS （2D-STI） single detection of myocardial ischemia after percutaneous coronary intervention in group PCI were 85.22% and 66.96%, and the specificity was 65.38% and 74.36%. The sensitivity oflMA and GPLS （2D-STI） combined detection of myocardial ischemia after percutaneous coronary intervention in group PCI was 64.35%, and the specificity was 93.59%. The specificity of combined detection was significantly higher than that of the single detection, there being statistical difference （P 〈 0.05）. Conclusion IMA combined with 2D-STI is helpful for the early diagnosis of UA, which can provide reference for clinical UA diagnosis.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2017年第4期339-342,共4页
Chinese Journal of Practical Internal Medicine
基金
山西省卫计委科研课题(2014026)
关键词
缺血修饰白蛋白
二维斑点追踪技术
不稳定型心绞痛
早期诊断
ischemia modified albumin
two-dimensional speckle tracking imaging
unstable angina pectoris
early diagnosis
