摘要
目的探讨超声心动图参数联合心电图T波振幅评估扩张型心肌病(DCM)患者左室收缩功能的临床价值。方法选取于我院就诊的DCM患者80例,根据纽约心脏病学会(NYHA)心功能分级将其分为NYHAⅡ级组(28例)、NYHAⅢ级组(26例)和NYHAⅣ级组(26例),均行超声心动图和同步12导联体表心电图检查,比较各组左室收缩末期容积(LVESV)、左室收缩末期内径(LVESD)、左室舒张末期容积(LVEDV)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)及心电图T波振幅的差异。分析超声心动图参数和心电图T波振幅与DCM患者心功能分级的相关性。绘制受试者工作特征(ROC)曲线分析超声心动图参数联合心电图T波振幅评估DCM患者左室收缩功能的诊断效能。结果各组LVESV、LVESD、LVEDV、LVEDD、LVEF比较差异均有统计学意义(均P<0.05)。NYHAⅡ级组、NYHAⅢ级组、NYHAⅣ级组Ⅱ、V4、V5、V6导联T波振幅均依次降低,差异均有统计学意义(均P<0.05)。LVESV、LVESD、LVEDV、LVEDD与DCM患者心功能分级均呈正相关(r=0.486、0.514、0.473、0.522,均P<0.001);LVEF与DCM患者心功能分级呈负相关(r=-0.564,P<0.001)。Ⅱ、V4、V5、V6导联T波振幅与DCM患者心功能分级均呈负相关(r=-0.538、-0.465、-0.530、-0.512,均P<0.001)。ROC曲线分析显示,超声心动图参数联合心电图T波振幅评估DCM患者左室收缩功能的曲线下面积为0.961(95%可信区间:0.927~0.981,P<0.001),高于其单独应用,差异均有统计学意义(均P<0.001)。结论超声心动图参数联合心电图T波振幅可准确评估DCM患者左室收缩功能,为临床诊治提供参考依据。
Objective To investigate the clinical value of echocardiographic parameters combined with electrocardiogram T-wave amplitude in evaluating left ventricular systolic function in patients with dilated cardiomyopathy(DCM).Methods A total of eighty patients with DCM admitted to our hospital were selected and divided into NYHAⅡgroup(n=28),NYHAⅢgroup(n=26)and NYHAⅣgroup(n=26)according to the cardiac function classification of the New York Heart Association(NYHA).Echocardiography and synchronous 12-lead combined table electrocardiogram were performed.Left ventricular end-systolic volume(LVESV),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic volume(LVEDV),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)and electrocardiogram Twave amplitude were compared among all groups.The correlation between echocardiographic parameters,electrocardiogram Twave amplitude and the cardiac function classification in DCM patients was analyzed.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of echocardiographic parameters combined with electrocardiogram T-wave amplitude in evaluating left ventricular systolic function in DCM patients.Results There were significant differences in LVESV,LVESD,LVEDV,LVEDD and LVEF among groups(all P<0.05).TheⅡ,V4,V5,V6 leads of T wave amplitude in NYHAⅡgroup,NYHAⅢgroup and NYHAⅣgroup were decreased in sequence,and the differences were statistically significant(all P<0.05).LVESV,LVESD,LVEDV,LVEDD were positively correlated with the cardiac function classification in DCM patients(r=0.486,0.514,0.473,0.522,all P<0.001),LVEF was negatively correlated with the cardiac function classification in DCM patients(r=-0.564,P<0.001).Ⅱ,V4,V5,V6 leads of T-wave amplitude were negatively correlated with the cardiac function classification in DCM patients(r=-0.538,-0.465,-0.530,-0.512,all P<0.001).ROC curve analysis showed that the area under the curve of echocardiographic parameters combined with electrocardiogram T-wave amplitude in evaluating left ventricular systolic function in DCM patients was 0.961(95%confidence interval:0.927~0.981,P<0.001),which was higher than individual application(all P<0.001).Conclusion Echocardiographic parameters combined with electrocardiogram T-wave amplitude can accurately evaluate left ventricular systolic function in DCM patients,and provide reference for clinical treatment.
作者
吕佳仁
江惠琼
许德星
LV Jiaren;JIANG Huiqiong;XU Dexing(Department of Cardiac Function Examination,Quanzhou First Hospital Affiliated of Fujian Medical University,Fujian 362000,China)
出处
《临床超声医学杂志》
CSCD
2023年第12期990-995,共6页
Journal of Clinical Ultrasound in Medicine
基金
福建省卫健委科技计划项目(2021TG025)。
关键词
超声心动描记术
心电图
T波振幅
扩张型心肌病
收缩功能
心室
左
Echocardiography
Electrocardiogram,T-wave amplitude
Dilated cardiomyopathy
Systolic function,ventricle,left
