压力-应变环对早期冠心病心肌做功改变的定量评估  

Evaluation of myocardial work changes in early coronary heart disease patients by pressure-strain loop

作　　者：吴秋玲 李华 唐莎 牛铭 WU Qiuling;LI Hua;TANG Sha;NIU Ming(Department of Cardiac Ultrasound,the Fourth Clinical Medical College of Xinjiang Medical University,Xinjiang Uygur Autonomous Region,Urumqi830000,China)

机构地区：[1]新疆医科大学第四临床医学院心脏超声科,新疆乌鲁木齐830000

出　　处：《中国医药导报》2021年第34期135-138,F0004,共5页China Medical Herald

基　　金：新疆维吾尔自治区自然科学基金项目(2015211 C147)。

摘　　要：目的探讨压力-应变环(PSL)评估早期冠心病患者左室心肌做功改变的价值。方法选取2018年6月至2020年9月新疆医科大学第四临床医学院(以下简称“我院”)收治的疑似冠心病患者68例,依据其冠状动脉造影结果分为轻度狭窄组(狭窄率<50%)27例和中度狭窄组(50%≤狭窄率<75%)41例,同时选择我院同期体检健康者30名作为对照组。应用PSL评估整体纵向应变(GLS)及心肌做功参数,心肌做功参数包括整体做功指数(GWI)、整体有用功(GCW)、整体无用功(GWW)、整体做功效率(GWE)。采用Pearson相关系数分析心肌做功参数与左室射血分数(LVEF)、GLS的相关性。采用受试者操作特征曲线及曲线下面积(AUC)分析心肌做功参数对冠心病的诊断价值。结果中度狭窄组GLS、GWW均高于对照组及轻度狭窄组,GWI、GCW、GWE均低于对照组及轻度狭窄组,差异有统计学意义(P<0.05)。GWI、GCW与LVEF呈正相关(r>0,P<0.05),与GLS呈负相关(r<0,P<0.05)。各心肌做功参数对冠心病均存在诊断价值(AUC>0.5,P<0.05)。结论PSL能较准确地评估冠心病患者心肌做功改变,为临床早期评估冠心病提供一种新的诊断依据。Objective To evaluate the left ventricular myocardial work changes in early coronary heart disease by pressure-strain loop(PSL).Methods A total of 68 patients with suspected coronary heart disease admitted to the Fourth Clinical Medical College of Xinjiang Medical University(hereinafter referred to as“our hospital”)from June 2018 to September 2020 were selected.According to their coronary angiography results,they were divided into mild stenosis group(stenosis rate<50%)(27 cases)and moderate stenosis group(50%≤stenosis rate<75%)(41 cases).At the same time,30 healthy subjects in our hospital were selected as control group.PSL was used to evaluate global longitudinal strain(GLS)and myocardial work parameters,including global work index(GWI),global constructive work(GCW),global wasted work(GWW),and global work efficiency(GWE).Pearson correlation coefficient was used to analyze the correlation between myocardial work parameters and left ventricular ejection fraction(LVEF)and GLS.The diagnostic value of myocardial work parameters in coronary heart disease was analyzed by using receiver operator characteristic curve and area under curve(AUC).Results The GLS and GWW of moderate stenosis group were higher than those of control group and mild stenosis group,while the GWI,GCW,and GWE of moderate stenosis group were lower than those of control group and mild stenosis group,the differences were statistically significant(P<0.05).GWI and GCW were positively correlated with LVEF(r>0,P<0.05),negatively correlated with GLS(r<0,P<0.05).All myocardial work parameters had diagnostic value for coronary heart disease(AUC>0.5,P<0.05).Conclusion PSL can accurately assess the changes of myocardial work in patients with coronary heart disease,providing a new diagnostic basis for early clinical evaluation of coronary heart disease.

关 键 词：冠心病 压力-应变环 左心室 心肌做功 

分 类 号：R541.4[医药卫生—心血管疾病]