摘要
目的 探讨心脏超声在肥厚型梗阻性心肌病(HOCM)诊断中的应用价值及其参数与患者左心室收缩功能的相关性。方法 选取2019年8月至2021年8月医院收治的HOCM 62例患者为研究组,以同期30名健康体检人员作为对照组。所有受试者均接受心脏超声检查,根据是否发生心脏不良事件(MACE)将62例HOCM患者分为不良组(33例)与良好组(29例)。比较不良组与良好组心脏超声参数,采用Spearman相关系数分析心脏超声参数与患者左心功能的相关性。绘制受试者工作特征(ROC)曲线分析心脏超声对HOCM患者的诊断价值。结果 研究组左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、左室缩短分数(LVFS)、左室周径纤维平均缩短速度(mVCF)水平低于对照组(P<0.05),左室收缩末期内径(LVESD)、左室每搏量(SV)、左室每分输出量(CO)、等容收缩时间(ICT)、左室后壁厚度、室间隔厚度、左室流出道压力水平高于对照组(P<0.05);良好组LVEDD、LVEF、LVFS、m VCF水平高于不良组(P<0.05),LVESD、SV、CO、ICT、左室后壁厚度、室间隔厚度、左室流出道压力水平低于不良组(P <0.05);Spearman相关分析显示HOCM患者左室收缩功能与LVEDD、LVEF、LVFS、mVCF水平呈正相关(r=0.52,r=0.71,r=0.69,r=0.60,P <0.05),与LVESD、SV、CO、ICT、左室后壁厚度、室间隔厚度、左室流出道压力呈负相关(r=-0.70,r=-0.63,r=-0.73,r=-0.71,r=-0.66,r=-0.68,r=-0.68,P<0.05);心脏超声诊断HOCM的ROC曲线下面积(AUC)为0.816 (95%CI:0.779~0.927),灵敏度和特异度分别为79.8%和78.1%,约登指数为0.579。结论 心脏超声参数与HOCM患者左心室收缩功能具有较强相关性,诊断价值较高。
Objective To explore the application value of echocardiography in the diagnosis of hypertrophic obstructive cardiomyopathy(HOCM) and the correlation between parameters and left ventricular systolic function of patients. Methods A total of 62 HOCM patients admitted to the hospital from August 2019 to August 2021 were selected as the research group, and 30 healthy persons undergoing physical examination during the same period were selected as the control group. All subjects underwent echocardiography, and 62 HOCM patients were divided into a poor group(33 cases) and a good group(29 cases) according to the occurrence of adverse cardiac events(MACE). The cardiac ultrasound parameters of the poor group and the good group were compared, and the Spearman correlation coefficient was used to analyze the correlation between the cardiac ultrasound parameters and the left ventricular function of the patients. Drawing receiver operating characteristic(ROC) curve to analyze the diagnostic value of cardiac ultrasound in patients with HOCM. Results The levels of left ventricular end′diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF), left ventricular fractional shortening(LVFS) and left ventricular peripheral fiber shortening velocity(mVCF) in the study group were lower than those in the control group(P<0.05), Study group left ventricular end′systolic diameter(LVESD), left ventricular stroke volume(SV), left ventricular output per minute(CO), isovolumic contraction time(ICT), left ventricular posterior wall thickness, ventricular septal thickness, left ventricular Outflow tract pressure level higher than control group(P<0.05). The levels of LVEDD, LVEF, LVFS and mVCF in the good group were higher than those in the poor group(P<0.05), The LVESD, SV, CO, ICT, left ventricular posterior wall thickness, interventricular septum thickness, and left ventricular outflow tract pressure levels in the good group were lower than those in the poor group(P<0.05). Spearman correlation analysis showed that left ventricular systolic function in HOCM patients was positively correlated with the levels of LVEDD, LVEF, LVFS and m VCF(r=0.52, r=0.71, r=0.69, r=0.60, P<0.05). Spearman correlation analysis showed that left ventricular systolic function in HOCM patients was negatively correlated with LVESD, SV, CO, ICT, left ventricular posterior wall thickness,ventricular septal thickness, and left ventricular outflow tract pressure(r=-0.70, r=-0.63, r =-0.73, r =-0.71, r =-0.66, r=-0.68, r=-0.68, P<0.05). The area under the ROC curve(AUC) of echocardiography in the diagnosis of HOCM was 0.816(95%CI: 0.779, 0.927), the sensitivity and specificity were 79.80% and 78.10%, respectively, and the Youden index was 0.579. Conclusion Cardiac ultrasound parameters have strong correlation with left ventricular systolic function in patients with HOCM, and have high diagnostic value.
作者
苗彦霞
Miao Yanxia(Department of Ultrasonography,Queshan County First People's Hospital,Henan,463200,China)
出处
《实用医学影像杂志》
2022年第5期451-454,共4页
Journal of Practical Medical Imaging
关键词
超声检查
心肌病
肥厚性
心室功能
左
Ultrasonography
Cardiomyopathy
Hypertrophic
Ventricular Function
Left
