摘要
目的:采用多普勒超声联合CT检查进行血流动力学与凝血功能评估,探讨其在非瓣膜性心房颤动(NVAF)患者诊断中的临床价值。方法:选取医院心内科接诊的200例NVAF患者,将未经抗凝治疗的100例NVAF患者纳入观察组,将心血管系统未见异常的100例NVAF患者纳入对照组。所有患者均采用超声心动图进行血流动力学指标的评估,并通过CT增强扫描进行血栓栓塞情况的检测,对左心房内径(LAD)、左心室舒张末内径(LVEDD)及左心室射血分数(LVEF)进行测评,采用受试者工作特征(ROC)曲线下面积(AUC)比较多普勒超声联合CT检查的诊断效能。结果:两组患者的年龄、体重指数、收缩压、舒张压、NVAF病程等基本资料比较无差异;观察组患者超声心动图测量LAD、LVEDD及LVEF的数值劣于对照组,差异有统计学意义(t=15.095,t=6.862,t=3.349;P<0.05);观察组患者头颅、肺动脉和心脏冠状动脉的血栓栓塞比例高于对照组,差异有统计学意义(x^(2)=24.100,x^(2)=13.580,x^(2)=34.621;P<0.05);以心电图为诊断标准,超声心动图诊断NVAF的AUC、灵敏度和特异度分别为0.892、89.1%和87.0%;CT影像诊断分别为0.913、84.5%和86.2%;超声联合CT诊断分别为0.946、96.7%和90.5%。结论:NVAF患者的血流动力学指标明显下降,凝血功能出现异常,多普勒超声联合CT检查方法能更准确地评估患者的生理状态和健康水平,为临床NVAF患者的治疗提供更全面的数据依据。
Objective: To assess hemodynamics and coagulation function by Doppler ultrasound combined with computed tomography(CT) examination, and to explore the clinical application value of that in the diagnosis of patients with nonvalvular atrial fibrillation(NVAF). Methods: A total of 200 NVAF patients admitted to cardiology department of hospital were selected, and 100 NVAF patients without anticoagulation therapy were included in observation group, and 100 NVAF patients without cardiovascular abnormalities were included in control group. All patients underwent echocardiography to assess the indicators of hemodynamics, and to detect thromboembolism by CT enhanced scanning. The left atrial diameter(LAD), left ventricular end-diastolic diameter(LVEDD) and left ventricular ejection fraction(LVEF) were measured and evaluated. The area under curves(AUCs) of receiver operating characteristics(ROCs) curve was adopted to compared the diagnostic efficiency of Doppler ultrasound combined with CT examination. Results: There were no significant differences in age, body mass index, systolic blood pressure,diastolic blood pressure and NVAF course between the two groups. The values of LAD, LVEDD and LVEF measured by echocardiography in observation group were significantly lower than those in control group, and the differences were statistically significant(t=15.095, t=6.862, t=3.349, P<0.05), respectively. The proportions of thromboembolism in head, pulmonary artery and heart coronary arteries in observation group were significantly higher than those in control group, and the differences were statistically significant(x^(2)=24.100, x^(2)=13.580, x^(2)=34.621, P<0.05), respectively.The electrocardiogram was used as the diagnostic standard, and the AUC, sensitivity and specificity of ultrasonic cardiogram were 0.892, 89.10% and 87.0% in diagnosing NVAF, respectively. And these indicators of CT image were 0.913, 84.5% and 86.2% in diagnosing NVAF, respectively. And these indicators of ultrasound combined with CT image were 0.946, 96.7% and 90.5% in diagnosing NVAF, respectively. Conclusion: Hemodynamic indicators of NVAF patients decreased significantly, and coagulation function of them was abnormal. Doppler ultrasound combined with CT examination can more accurately assess the physiological status and health level of patients, and provide more comprehensive data basis for clinical treatment of NVAF patients.
作者
周巍
马晓峰
曹建东
ZHOU Wei;MA Xiao-feng;CAO Jian-dong(Department of Cadre Health Care,Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital,Xining 810012,China)
出处
《中国医学装备》
2022年第10期71-75,共5页
China Medical Equipment
基金
青海省卫健委医药卫生科技项目(2019-wjzdx-81)“高海拔世居人群炎症因子和氧化应激与心房颤动相关性的对照研究”
青海省心脑血管病专科医院院内科研课题(2021-qxyn-35)“高海拔地区心房颤动患者的血凝因子与动脉系统血栓形成相关研究”。
