左心室二维整体纵向应变评估非ST段抬高型急性冠状动脉综合征患者冠状动脉狭窄的Meta分析  

Assessment of coronary artery stenosis using two-dimensional left ventricular global longitudinal strain in patients with non ST-elevation acute coronary syndrome:a Meta-analysis

作　　者：王诗彤 朱晴 王舒俣 王永槐[1] 李光源[1] 孔凡鑫 杨军[1] 马春燕[1] WANG Shi-tong;ZHU Qing;WANG Shu-yu;WANG Yong-huai;LI Guang-yuan;KONG Fan-xin;YANG Jun;MA Chun-yan(Department of Cardiovascular Ultrasound,The First Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院心血管超声科,辽宁省沈阳市110001

出　　处：《中国心血管病研究》2020年第12期1076-1081,共6页Chinese Journal of Cardiovascular Research

基　　金：国家自然科学基金(81901766,81871373)。

摘　　要：目的 系统评价二维左心室整体纵向应变(LVGLS)在非ST段抬高型急性冠状动脉综合征(NSTE-ACS)患者中评估冠状动脉狭窄程度超过50%(CAD≥50)的能力.方法 系统检索Pubmed、The Cochrane Library、Embase、万方以及中国知网数据库,检索时间截至2020年4月.纳入超声二维斑点追踪技术(2D-STE)所得的LVGLS在NSTE-ACS患者中评估CAD≥50的诊断性研究,采用Meta Disc 1.4及Stata 15.0统计软件进行Meta分析.结果 共纳入8篇研究,780名研究对象.Meta分析结果显示,合并后的敏感度为0.82(95%CI 0.78~0.86),特异度为0.72(95%CI 0.67~0.76),阳性似然比为3.03(95%CI 2.55~3.61),阴性似然比为0.23(95%CI 0.18~0.29),诊断比值比为13.34(95%CI 9.41~18.93)及曲线下面积为0.85.且CAD≥50组与冠状动脉狭窄程度小于50%(CAD<50)组合并后的LVGLS平均值分别为-16.60%(95%CI-0.17^-0.16)与-20.84%(95%CI-0.22^-0.20).在针对左心室射血分数(LVEF)正常或室壁运动积分指数(WMSI)正常的亚组中也得到了相似的结果.结论 在NSTE-ACS患者中,LVGLS对于NSTE-ACS患者冠状动脉狭窄程度的评估有较高的准确性和诊断效能,可作为临床评估冠状动脉狭窄程度的有效方法.Objective To evaluate the diagnostic value of two-dimensional left ventricular global longitudinal strin(LVGLS)to ases coronary artery discse(CAD)with stnosis exceding 50%(CADs)in paticnts with non ST-elevation acute coronary syndrome(NSTE ACS).Methods PubMed,the Cochrane Library,Embase,Wanfang and CNKI databases were systematicallly searched,with the search time set from inception to April 2020.Diagnostic studies of ssessment of CADso using LVGLS derived from two-dimensional specke tracking echocardiography(2D-STE)in patients with NSTE-ACS were included and the meta-analysis was performed by Meta Disc 1.4 and Stata 15.0 satitical software.Results Eight studies were included with the total of 780 subjcts eventually.The resuts of meta analysis indicted that the pooled senstivity was 0.82(95%CI 0.78-0.86)and the speificiy was 0.72(95%CI 0.67-0.76),with a 3.03 positiv likelihoo raio(95%Cc1255-3.61)and e 0.23 negative lkelihoo ratio(95%CI 0.18-0.29);the diagnostic odds ratio was 13.34(95%CI 9.41-18.93)and the area under the curve was 0.85.In addition,the mean value of LVGLS was-16.60%(95%CI-0.17--0.16)and-20.84%(95%CI-0.22--0.20)respectivly,in the group with CADso and the group with CAD with stenosis less than 50%(CADs).Similar result was also obtained in the subgroup with normal left vntricular ejectio facion(IVEF)or normal wall motion index(WMSI).Conclusion In NSTEACS patients,LVGLS has a higher accuracy and diagnostic ffcacy in asessing the degree of coronary artery stenosis,which can be used as an effective tool for clinical evaluation of the degree of coronary artery stenosis.

关 键 词：斑点追踪 非ST段抬高性急性冠状动脉综合征 冠状动脉狭窄 整体纵向应变 心肌 左心室 META分析 

分 类 号：R543.3[医药卫生—心血管疾病]