左室压力-应变环对冠心病患者整体心肌做功的研究  

Evaluation of Myocardial Work in Patients with Coronary Artery Disease Using Left Ventricular Pressure-strain Loops

作　　者：王然然 李守强[1] 于丹丹[1] 田家玮[1] 冷晓萍[1] Wang Ranran;Li Shouqiang;Yu Dandan;Tian Jiawei;Leng Xiaoping(Department of Ultrasound,The Second Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang 150081,China)

机构地区：[1]哈尔滨医科大学附属第二医院超声医学科,哈尔滨市150081

出　　处：《中国超声医学杂志》2021年第6期632-636,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的应用左室压力-应变环(LV PSL)评估射血分数(EF)及室壁运动正常的冠心病患者的整体心肌做功情况,探讨心肌做功参数在诊断冠心病中的临床价值。方法选取临床疑诊为冠心病并进行冠脉造影的患者112例,根据冠脉造影(CAG)结果分为对照组30例,冠心病组82例,其中冠心病组分为单支组40例及多支组42例,利用LV PSL分析各心肌做功参数,包括整体做功指数(GWI)、整体有效功(GCW)、整体无效功(GWW)、整体做功效率(GWE)。结果与对照组相比,冠心病组GWI、GCW、GWE均显著减低,GWW显著升高(P<0.05)。与冠心病单支组相比,多支组GWI明显降低(P<0.05),GCW、GWW、GWE两组间比较无明显差异。ROC曲线显示GWI、GCW、GWW、GWE的曲线下面积分别为0.839、0.821、0.910、0.958;GWE截断值为95.6%,预测冠心病的灵敏度及特异度分别为93.5%、92.3%。结论LV PSL可量化分析冠心病患者的心肌做功,其中GWE是反映冠心病患者左室功能改变的较灵敏指标。Objective Using the non-invasive left ventricular(LV) pressure-strain loops(PSL) to obtain the global myocardial work(MW) parameters of coronary artery disease(CAD)patients with normal ejection fraction(EF) and wall motion, and to explore the clinical value of MW parameters in the diagnosis of CAD. Methods The Second Affiliated Hospital of Harbin Medical University, 112 patients suspected with CAD who underwent coronary angiography(CAG) are selected. According to the results of CAG, the patients are divided into control group 30 cases, CAD group 82 cases, CAD group was then divided into single-vessel group 40 cases and multivessel group 42 cases. The LV PSL was used to analyze the global MW parameters, including the global work index(GWI), global constructive work(GCW), global wasted work(GWW) and global work efficiency(GWE). Results Compared with those in control group, GWI, GCW and GWE in CAD group all decreased significantly and GWW increased(P<0.05). There was a significant difference in GWI between the multivessel group and single-vessel group in CAD patients. There was no significant difference in GCW, GWW and GWE between multivessel group and single-vessel group. ROC curve showed that the area under the curve of GWI, GCW, GWW and GWE was 0.839,0.821,0.910 and 0.958 respectively. The cut off value of GWE was 95.6%, the sensitivity and specificity of GWE in predicting CAD were respectively 93.5% and 92.3%. Conclusions LV PSL is able to quantitatively analyze MW in CAD patients. GWE is a more sensitive indicator of LV function changes in patients with CAD.

关 键 词：超声心动图 应变 心肌做功 冠心病 

分 类 号：R540.45[医药卫生—心血管疾病] R541.4[医药卫生—内科学]