实时三维超声心动图定量评价冠心病患者左室收缩不同步性的初步临床研究  

Preliminary clinical study of left ventricular systolic dyssynchrony in patients with coronary heart disease by real-time three-dimensional echocardiography

作　　者：观志强[1] 钟雪菁 郑宝群[1] 姚怀齐[1] 陈畅[2] 

机构地区：[1]汕头大学医学院第一附属医院超声科,广东省汕头515041 [2]汕头大学医学院第一附属医院心内科,广东省汕头515041 [3]东莞市人民医院超声科,广东省东莞523000

出　　处：《中国基层医药》2017年第14期2127-2130,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：基金项尉：广东省公益研究和能力建设专项资金项目（2014A020212414）

摘　　要：目的 探讨实时三维超声心动图（RT-3DE）定量评价冠心病患者左室收缩不同步性的临床价值.方法 临床怀疑冠心病患者共80例,先用Siemens Acuson SC 2000超声诊断仪采集左室三维全容积动态图像,经后处理显示射血分数（EF）及左室收缩同步性参数：16节段心缩非同步指数（SDI 16）;再行冠脉造影检查,根据冠脉造影结果,定义受检者血管狭窄≥50%纳入冠心病组,受检者血管狭窄〈50%纳入冠状动脉粥样硬化组,造影结果正常纳入对照组.比较各组不同参数间差异.结果 三组间EF差异均无统计学意义（均P〉0.05）.SDI 16在对照组及冠状动脉粥样硬化组间差异无统计学意义（t=-1.03,P〉0.05）.SDI 16在对照组[（3.72±2.68）%]与冠心病组[（7.14±3.10）%]、冠状动脉粥样硬化组[（5.12±3.46）%]与冠心病组[（7.14±3.10）%]差异均有统计学意义（t=-3.71、-2.34,均P〈0.05）.ROC以SDI 16〉5.49%作为评价冠心病组截断值,敏感性为81.8%,特异性为73.1%（AUC=0.743）.结论 SDI 16〉5.49%可作为Siemens Acuson SC 2000超声诊断仪RT-3D定量评价冠心病患者左室收缩不同步的重要截点,有一定临床价值.Objective To figure out the preliminary clinical value of real-time three-dimensional echocardiography（RT-3DE） in evaluating the systolic dyssynchrony in patients with coronary artery heart disease（CAD）.Methods Eighty patients who were suspected as CAD were included in this study.RT-3DE was performed first.After the analysis,we got the data：ejection fraction （EF）,16 segments systolic dyssynchronic index （SDI 16）.All subjects should take the coronary angiography.According to coronary angiography results,the patients with the vascular stenosis rate ≥50% were defined as the CAD group,and the patients with the vascular stenosis rate 〈50% were defined as the coronary atherosclerosis group,the patients with the completely normal angiographic results were included in the control group according to the results of angiography.The parametric differences among the groups were compared.Results There was no significant difference in LVEF among the three groups.SDI 16 had no significant difference between the control group and the coronary atherosclerosis group （t=-1.03,P〉0.05）.However,SDI 16 had significant difference between the control group[（3.72±2.68）%]and the CAD group[（7.14±3.10）%],the same between coronary atherosclerosis group[（5.12±3.46）%]and the CAD group[（7.14±3.10）%]（t=-3.71,-2.34,all P〈0.05）.ROC curve analysis revealed that a cut-off value for SDI of 5.49%,yielded a sensitivity of 81.8%,with a specificity of 73.1% to predict coronary atherosclerosis to CAD（AUC=0.743）.Conclusion SDI 16 〉5.49% has a higher value in evaluating systolic dyssynchrony in patients with CAD with RT-3D of Siemens Acuson SC2000 ultrasonic diagnostic instrument.

关 键 词：冠状动脉疾病 超声心动描记术 压力 

分 类 号：R540.45[医药卫生—心血管疾病]