三维超声心动图自动测定舒张性心衰患者预测价值  

Automatic determination of three-dimensional echocardiography predicting diastolic heart failure in patients with

作　　者：胡乙君 李灿[1] 李晓娟 郭雅婧[1] Hu Yijun;Li Can;Li Xiaojuan;Guo Yajing(Department of Ultrasound,the First People's Hospital of Chenzhou Chenzhou 423000,Hunan,China)

机构地区：[1]郴州市第一人民医院超声科,湖南郴州423000

出　　处：《现代科学仪器》2021年第5期161-166,共6页Modern Scientific Instruments

摘　　要：目的:探讨三维超声心动图自动定量技术(3D-HM)测定舒张性心衰(DHF)患者左室容积参数与心衰标志物相关性及对主要心血管不良事件(MACE)的预测价值。方法:选取我院2016年2月~2020年6月DHF患者126例,根据随访6个月是否发生MACE分为MACE组(21例)与无MACE组(105例)。比较两组N-端脑钠肽前体(NT-ProBNP)、3D-HM测定左室容积参数[左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心房最大容积(LAV)],分析3D-HM检查结果与血清NT-ProBNP水平、NYHA分级相关性及预测MACE的价值。结果:两组年龄、病程、NYHA分级对比,差异有统计学意义(P<0.05);MACE组血清NT-ProBNP高于无MACE组,LVEDV、LVESV、LAV大于无MACE组(P<0.05);随NYHA分级增加,血清NT-ProBNP水平、LVEDV、LVESV、LAV呈升高趋势(P<0.05);LVEDV、LVESV、LAV与血清NT-ProBNP、NYHA分级呈正相关(P<0.05);LVEDV、LVESV、LAV联合预测价值最高,截断值敏感度为95.24%,截断值特异度为77.14%。结论:3D-HM检查结果与DHF患者心衰标志物水平及心功能具有密切关联性,可作为临床评估DHF患者MACE发生风险的有效补充,为临床完善治疗方案提供参考。Objective:To investigate the correlation between the three-dimensional echocardiography heart model(3D-HM)in the determination of left ventricular volume parameters and heart failure markers in patients with diastolic heart failure(DHF)and its predictive value for major adverse cardiovascular events(MACE).Methods:From February 2016 to June 2020,126 patients with DHF in our hospital were selected and divided into MACE group(21 cases)and non-MACE group(105 cases)according to whether MACE occurred during the 6-month follow-up.The N-terminal pro-brain natriuretic peptide(NT-ProBNP)and left ventricular volume parameters measured by 3D-HM[left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),left atrium maximum volume(LAV)]were compared between the two groups.The correlation between 3D-HM inspection results and serum NT-ProBNP levels,NYHA grade and the value of predicting MACE were analyzed.Results:There was a statistically significant difference in age,course of disease and NYHA classification between the two groups(P<0.05).Serum NT-ProBNP of MACE group was higher than that of non-MACE group,and LVEDV,LVESV and LAV were higher than that of non-MACE group(P<0.05).With the increase of NYHA grade,serum NT-ProBNP levels,LVEDV,LVESV,LAV showed an increasing trend(P<0.05).LVEDV,LVESV,LAV were positively correlated with serum NT-ProBNP and NYHA grades(P<0.05).The combined predictive value of LVEDV,LVESV and LAV was the highest,with a cut-off sensitivity of 95.24%and a cut-off specificity of 77.14%.Conclusion:3D-HM examination results are closely related to the levels of heart failure markers and heart function in DHF patients,and can be used as an effective supplement for clinical assessment of the risk of MACE in DHF patients and provide a reference for clinical improvement of treatment plans.

关 键 词：三维超声心动图自动定量技术 舒张性心衰 主要心血管不良事件 左心房最大容积 N-端脑钠肽前体 

分 类 号：R54[医药卫生—心血管疾病]