[1]宿海峰,裴娟慧,甘 丰,等.实时三维超声心动图诊断节段性室壁运动异常冠心病患者临床价值研究[J].陕西医学杂志,2023,52(7):822-825,830.[doi:DOI:10.3969/j.issn.1000-7377.2023.07.010]
　SU Haifeng,PEI Juanhui,GAN Feng,et al.Clinical value of RT-3DE in coronary heart disease patients with segmental ventricular wall movement abnormalities[J].,2023,52(7):822-825,830.[doi:DOI:10.3969/j.issn.1000-7377.2023.07.010]
点击复制

实时三维超声心动图诊断节段性室壁运动异常冠心病患者临床价值研究
分享到：

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年7期
页码:
822-825,830
栏目:
临床研究
出版日期:
2023-07-05

文章信息/Info

Title:
Clinical value of RT-3DE in coronary heart disease patients with segmental ventricular wall movement abnormalities
作者:
宿海峰1; 裴娟慧1; 甘 丰1; 崔丽萍 2; 郭 艳2
(1.北京航天总医院心内科,北京100760; 2.解放军总医院第二医学中心心内科, 北京 100036)
Author(s):
SU Haifeng; PEI Juanhui; GAN Feng; CUI Liping; GUO Yan
(Department of Cardiology,Beijing Aerospace General Hospital,Beijing 100760,China)
关键词:
冠心病;  节段性室壁运动异常;  实时三维超声心动图;  诊断;  整体心功能参数
Keywords:
Coronary disease;  Regional wall motion abnormality;  Real-time three-dimensional echocardiography;  Diagnosis;  Overall cardiac function parameter
分类号:
R 540.4
DOI:
DOI:10.3969/j.issn.1000-7377.2023.07.010
文献标志码:
A
摘要:
目的:探究实时三维超声心动图(RT-3DE)在冠心病节段性室壁运动异常患者动脉病变的临床价值。方法:选取接受冠状动脉造影检查的有明显节段性左室壁运动异常的冠心病患者100例为观察组; 另选择同期100例冠脉造影正常者为对照组,两组均进行心脏RT-3DE检查分析,比较两组左室收缩末容积(LVESV)、左心室舒张末容积(LVEDV)、左心室射血分数(LVEF)、左心室心肌质量(LVM)、左心室重构指数(LVRI)数值,以及整体心功能参数,并对图像采用定量分析软件进行处理和分析。结果:与对照组比较,观察组患者的左心室基底段、中间段的局部舒张期末期容积(REDV)、局部收缩末期容积(RESV)均较高(均P<0.05)。与对照组比较,RT-3DE检测的观察组(单只、双只、多只病变)整体心功能参数LVEDV、LVESV升高,LVEF、LVRI降低(均P<0.05),两组LVM比较无统计学差异(P>0.05)。对照组左心室容积-时间曲线(VTC)排列有序,各节段曲线形态一致,各曲线的波峰、波谷的横坐标位置接近,时间牛眼图上左室整体达收缩末期时间相近为绿色,位移牛眼图上运动正常为蓝色; 观察组病变区域VTC形态不规则、杂乱,曲线的波峰、波谷后移,时间牛眼图上为红色,其周围节段出现蓝色、绿色,位移牛眼图上为黑色。受试者工作体征曲线(ROC曲线)结果显示,RT-3DE在冠心病节段性室壁运动异常患者冠状动脉病变检测的灵敏性为68.59%,特异度为85.72%,曲线下面积(AUC)值为0.866。结论:RT-3DE可分析评估冠心病患者节段性室壁运动异常,并可对冠状动脉病变进行定量分析,在临床检测中具有较高的应用价值。
Abstract:
Objective:To explore the clinical value of RT-3DE in coronary artery disease patients with segmental ventricular wall movement abnormalities.Methods:A total of 100 patients with coronary heart disease and significant segmental left ventricular wall motion abnormalities who underwent coronary angiography were selected as the observation group.Another 100 patients with normal coronary angiography in the same period were selected as the control group.RT-3DE was performed in both groups to compare the values of ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV),left ventricular ejection fraction(LVEF),left ventricular myocardial mass(LVM),left ventricular remodeling index(LVRI)and overall cardiac function parameters,and the image was processed and analyzed by quantitative analysis software.Results:Compared with the control group,the local REDV and RESV of the basal and middle segments of the left ventricle in the observation group were higher(all P<0.05).Compared with the control group,the cardiac function parameters LVEDV and LVESV were increased,and LVEF and LVRI were decreased in the observation group(single,double and multiple animals)detected by RT-3DE(all P<0.05),and there was no difference in LVM between the two groups(P>0.05).The left ventricular volume-time curve of the control group was arranged in anorderly manner,and the curve shape of each segment was consistent.The horizontal coordinates of the peaks and valleys of each curve were close.The end time of the overall contraction of the left ventricle on the time bull's eye diagram was similar to green,and the movement on the displacement bull.ROC curve results showed that the sensitivity,specificity and AUC value of RT-3DE were 68.59%,85.72% and 0.866 in the detection of arterial lesions in coronary heart disease patients with abnormal segmental wall motion.Conclusion:RT-3DE can be used to analyze and evaluate the abnormal segmental wall motion in patients with coronary heart disease,and to quantitatively analyze the arterial lesions,which has high application value in clinical detection.

参考文献/References:

[1] Mensah GA,Roth GA,Fuster V.The global burden of cardiovascular diseases and risk factors:2020 and beyond[J].J Am Coll Cardiol,2019,74(20):2529-2532.
[2] 刘 渊,崔 艳.冠心病患者血液检验相关指标临床观察[J].陕西医学杂志,2021,50(7):875-877,881.
[3] 李艳艳,贾 伟.24 h动态心电图在2型糖尿病合并冠心病患者心律诊断中的价值分析[J].陕西医学杂志,2019,48(1):61-63,70.
[4] 席新龙,王 君,赵 棉,等.同型半胱氨酸与冠心病、尿酸及血脂的相关性研究[J].陕西医学杂志,2018,47(11):1471-1473.
[5] 姜 峰,郭海健,陆 齐.实时三维斑点追踪成像评价阵发性房颤患者左心房功能的价值[J].中国超声医学杂志,2022,38(3):286-289.
[6] 唐 云,谢晓泉,蔡学锋.RT-3DE在急性心肌梗死患者PCI术后的应用价值[J].当代医药论丛,2022,(20):156-159.
[7] 冯 娟,闫奎坡,朱明军,等,瓜蒌薤白半夏汤联合血府逐瘀汤从痰瘀论治冠心病心绞痛疗效Meta分析[J].陕西中医,2021,42(3):393-397.
[8] 汪思慧,沈 雁.从“络以辛为泄”论治冠心病心绞痛研究进展[J].陕西中医,2022,43(12):1822-1824.
[9] 郭泽君.超声心动图诊断冠心病的Ⅰ期临床应用分析[J].中国现代医生,2017,55(28):98-101.
[10] 何炯红,杨 龙,卜 婕,等.3DSTI,2DE 和 MRI 检测扩张型心肌病患者左心室收缩功能结果的比较[J].临床心血管病杂志,2018,34(5):454-456.
[11] 张丽华,杜 超,曹亚坤,等.实时三维超声心动图评价球囊缺血后适应对急性前壁心肌梗死患者心脏收缩功能的作用[J].疑难病杂志,2019,18(11):1086-1090.
[12] 张立平,邢建华,周杏玉.实时三维及二维超声心动图联合应 用在心血管疾病诊断中的意义[J].现代医学,2014,42(12):1390-1395.
[13] 庞宏虹.实时三维超声心动图对左室整体及局部收缩功能的临床价值分析[J].当代医学,2015,21(9):71-72.
[14] 余 莉,文 东,刘 涛.RT-3DE对于AMI患者左心室节段性收缩功能及左心室重构的评价[J].中国循证心血管医学杂志,2017,9(7):831-833.
[15] 唐 云,谢晓泉,蔡学锋.RT-3DE在急性心肌梗死患者PCI术后的应用价值[J].当代医药论丛,2022,20(20):156-159.
[16] 马丽娜,姚民强,王佩显,症状期酒精性心肌病患者心脏结构和功能的超声评价[J].山东大学学报:医学版,2011,49(1):82-85.
[17] 田 园,王 伟,周长钰,实时三维超声及二维斑点追踪技术对拟诊冠心病患者局部室壁运动的评价[J].天津医药,2014,42(12):1229-1233.
[18] 郑锦滨,黄贤生.RT-3DE 评价急性心肌梗死患者左心室局部功能变化的价值分析[J].内科急危重症杂志,20l8,24(3):213-216.
[19] Lang RM,Badano LP,Mor-Avi V,et al.Recommendations for cardiac chamber quantification by echocardiograPhy in adults:An uPdate from the american society of echocardiogra phy and the euro pean association of cardiovascular imaging[J].Eur Heart J Cardiovasc Imaging,20l6,17(4):412.
[20] 滕 花,任建丽,冉海涛,等.三维超声心动图自动定量技术在评价左心腔容积及功能中的应用价值[J].中华超声影像学杂志,2019,28(3):192-199.

相似文献/References:

[1]李艳艳,贾 伟△.24h动态心电图在2型糖尿病合并冠心病患者心律诊断中的价值分析[J].陕西医学杂志,2019,(1):61.
[2]汤克虎,高峻峰,任尽平.药物涂层球囊在糖尿病患者冠状动脉小血管病变治疗中的应用研究*[J].陕西医学杂志,2019,(4):432.
[3]马党捐 ,康彦智 ,柴茂林.64排128层螺旋CT冠状动脉成像在冠心病患者诊断中的价值研究*[J].陕西医学杂志,2019,(5):624.
　MA Dangjuan,KANG Yanzhi,CHAI Maolin..Value analysis of 64rows 128slice spiral CT coronary angiography in the diagnosis of patients with coronary heart disease[J].,2019,(7):624.
[4]沈 琳,马文苑.曲美他嗪联合氯吡格雷治疗冠心病心绞痛疗效及对患者心电图、血清超敏C反应蛋白和五聚素3的影响[J].陕西医学杂志,2019,(6):794.
　SHEN Lin,MA Wenyuan.ElectrocardiogramRoom,Therapeutic Effect ofTrimetazidine Combined with Clopidogrel on Angina Pectoris and its Hs-CRP[J].,2019,(7):794.
[5]杨延洁,周慧龙△.不同双抗血小板疗程对冠心病合并房颤PCI术后患者远期预后的影响*[J].陕西医学杂志,2019,(12):1653.
[6]魏 勇,梁 琪,左浩源,等.右美托咪定预处理对冠心病非心脏手术患者心肌的保护作用*[J].陕西医学杂志,2019,(12):1706.
　WEI Yong,LIANG Qi,ZUO Haoyuan,et al.Protective effect of dexmedetomidine preconditioning on myocardium in patients with coronary heart disease undergoing nonheart surgery[J].,2019,(7):1706.
[7]刘玉珊.心外膜脂肪定量及可溶性血栓调节蛋白与冠心病病变程度相关性分析[J].陕西医学杂志,2020,49(1):44.
　LIU Yushan..Correlation between the distribution of epicardial adipose tissue and soluble thrombomodulin and the severity of coronary heart disease[J].,2020,49(7):44.
[8]赵 博,王银谦,王红燕.巨噬细胞移动抑制因子与冠心病关系Meta分析[J].陕西医学杂志,2020,49(1):125.
[9]王亚平,彭春艳,朱名安Δ.冠心病合并代谢综合征患者固醇调节元件结合蛋白表达水平与脂代谢指标相关性研究*[J].陕西医学杂志,2020,49(4):419.
　WANG Yaping,PENG Chunyan,ZHU Mingan..Correlation between the levels of SREBPs and the indicators of lipid metabolism in patients with coronary heart disease complicated with metabolic syndrome[J].,2020,49(7):419.
[10]南格利.冠心病颈动脉超声参数与斑块稳定性及炎症反应水平相关性分析[J].陕西医学杂志,2020,49(4):453.
　NAN Geli..Correlation between carotid ultrasound parameters and plaque stability and inflammatory response in patients with coronary heart disease[J].,2020,49(7):453.

备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助面上项目(81370287); 北京市首都卫生发展基金资助项目(SF2018-4-5013)
更新日期/Last Update: 2023-07-05