[1]张小用,肖仁喜,方 媛.左心室心肌收缩力在体计算方法及其临床应用价值[J].陕西医学杂志,2023,52(11):1526-1529.[doi:DOI:10.3969/j.issn.1000-7377.2023.11.016]
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左心室心肌收缩力在体计算方法及其临床应用价值
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年11期
页码:
1526-1529
栏目:
临床研究
出版日期:
2023-11-05

文章信息/Info

作者:
张小用1肖仁喜2方 媛1
(1.西安医学院第一附属医院超声科,陕西 西安 710077; 2.瑞昌市人民医院功能检查科,江西 瑞昌 332200)
关键词:
慢性心力衰竭 超声心动图 心肌收缩力 左心室 心肌收缩力比值 射血分值
分类号:
R 541.61
DOI:
DOI:10.3969/j.issn.1000-7377.2023.11.016
文献标志码:
A
摘要:
目的:探讨左心室心肌收缩力的在体计算方法及其在心脏功能与慢性心力衰竭评价中的价值。方法:检测32例慢性心力衰竭[左心室射血分值(LVEF)值<50%]患者(研究组)与35例心脏功能正常(LVEF 值≥50%)者(对照组)的超声心动图。超声心动图测量左心室质量(LVM)、质量指数(LVMI)及LVEF值; 椭球体表面积法估算左心室舒张末表面积(LVEDS)与收缩末表面积(LVESS); 依据帕斯卡定律与物理学上压强的基本概念计算左心室等容收缩期最大收缩力(F1)、左心室射血期末最大收缩力(F2); 单位心肌质量收缩力F1/LVM、F2/LVM及最大收缩力比值(F1/F2)。分析F1、F2、F1/LVM、F2/LVM及F1/F2在两组中的差异及与LVEF值的相关性; 探讨F1/F2诊断慢性心力衰竭的效能及受试者工作特征(ROC)曲线下面积。结果:研究组F1、F2、F2/LVM均大于对照组[(117.9±37.3)N与(100.5±25.3)N,t=2.259,P=0.027]; [(129.8±45.4)N 与(72.4±21.7)N,t=6.690,P<0.001]; [(0.55±0.17)与(0.40±0.12),t=5.831,P<0.001)],而F1/F2小于对照组[(0.93±0.13)与(1.44±0.35),t=-7.856,P<0.001)]。F2、F1/F2、F2/LVM及与LVEF值呈线性相关(r=-0.725、0.696、-0.426,均P<0.001)。F1/F2<1诊断慢性心力衰竭的敏感性90.62%,特异性94.29%,约登指数0.8491,ROC曲线下面积0.950。结论:慢性心力衰竭患者左心室收缩的力学模式发生改变,射血期末需要更多收缩力。F2、F1/F2及F2/LVM与LVEF值相关性好,可作为心脏功能评价的新指标,F1/F2<1可用于诊断慢性心力衰竭。

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备注/Memo

备注/Memo:
基金项目:西安市科技计划项目[2017117SF/YX011(13)]
更新日期/Last Update: 2023-11-06