冠心病患者超声心动图指标与冠脉狭窄程度、心功能的相关性  

Correlation among coronary stenosis severity,heart function and echocardiographic indexes in patients with coronary heart disease

作　　者：杨晓青 王立美 王紫韫 王晓辉 李洁[1] 王小颖 YANG Xiao-qing;WANG Li-mei;WANG Zi-yun;WANG Xiao-hui;LI Jie;WANG Xiao-ying(Department of Ultrasound,People's Hospital of Shijiazhuang City,Shijiazhuang,Hebei,050011,China)

机构地区：[1]石家庄市人民医院超声科,河北石家庄050011

出　　处：《心血管康复医学杂志》2022年第6期729-733,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：河北省医学科学研究课题计划项目(20201415)。

摘　　要：目的:研究冠心病(CHD)患者超声心动图(ECG)指标与冠脉狭窄程度、心功能的相关性。方法:选择于我院行冠脉造影的145例CHD患者为CHD组,120例健康者为健康对照组,比较两组一般临床资料及ECG指标:LVEDd、LVESV、LVEDV、LVEF。依据NYHA心功能分级,CHD组被分为NYHA I+Ⅱ级组(58例)、Ⅲ级组(54例)与Ⅳ级组(33例),比较各组ECG指标。依据Gensini评分,CHD组被分为轻度狭窄组(<20分,45例)、中度狭窄组(20~50分,63例)与重度狭窄组(>50分,37例),比较各组ECG指标及Gensini评分。结果:与健康对照组比较,CHD组LVEDd、LVESV、LVEDV均显著升高,LVEF显著降低(P均=0.001)。心功能指标:LVEDd、LVESV、LVEDV,NYHA I+Ⅱ级组<Ⅲ级组<Ⅳ级组,LVEF:NYHA I+Ⅱ级组>Ⅲ级组>Ⅳ级组,两两比较均有显著差异,P均<0.01。LVEDd、LVESV、LVEDV、Gensini评分:轻度狭窄组<中度狭窄组<重度狭窄组,LVEF:轻度狭窄组>中度狭窄组>重度狭窄组,两两比较均有显著差异,P均<0.01。Pearson及Spearman相关性分析显示,Gensini评分、NYHA心功能分级与LVEDd、LVESV、LVEDV呈显著正相关(r=0.476~0.832,P均=0.001),与LVEF呈显著负相关(r=-0.686,-0.744,P均=0.001)。ROC曲线显示,LVEDd、LVESV、LVEDV、LVEF联合预测冠心病的曲线下面积(AUC)为0.962,灵敏度为92.41%,特异度为83.33%;且显著高于各项单独检测(P<0.05或<0.01)。结论:LVEDd、LVESV、LVEDV、LVEF与冠脉狭窄程度和心功能显著相关,且四项联合检测对冠心病具较高预测价值。Objective:To study correlation among coronary stenosis severity,heart function and echocardiography(ECG)indexes in patients with coronary heart disease(CHD).Methods:A total of 145 CHD patients undergoing coronary angiography in our hospital were selected as CHD group.Another 120 healthy volunteers were simultaneously regarded as healthy control group.General clinical data and ECG indexes:LVEDd,LVESV,LVEDV and LVEF were compared between two groups.According to NYHA cardiac function classification,CHD group was divided into NYHA class I+Ⅱgroup(n=58),classⅢgroup(n=54)and classⅣgroup(n=33),and ECG indexes were compared among all group.According to Gensini score,CHD group was divided into mild stenosis group(<20 scores,n=45),medium stenosis group(20~50 scores,n=63)and severe stenosis group(>50 scores,n=37),and ECG indexes and Gensini score were compared among all groups.Results:Compared with healthy control group,there were significant rise in LVEDd,LVESV and LVEDV,and significant reduction in LVEF in CHD group(P=0.001 all).LVEDd,LVESV and LVEDV:NYHA class I+Ⅱgroup<classⅢgroup<classⅣgroup,LVEF:NYHA class I+Ⅱgroup>classⅢgroup>classⅣgroup,there existed significant difference between any two groups,P<0.01 all.LVEDd,LVESV,LVEDV and Gensini score:mild stenosis group<medium stenosis group<severe stenosis group,LVEF:mild stenosis group>medium stenosis group>severe stenosis group,there existed significant difference between any two groups,P<0.01 all.Pearson and Spearman correlation analysis indicated that Gensini score and NYHA cardiac function class were significant positively correlated with LVEDd,LVESV and LVEDV(r=0.476~0.832,P=0.001 all),and significant negatively correlated with LVEF(r=-0.686,-0.744,P=0.001 both).ROC curve analysis indicated that AUC of LVEDd,LVESV,LVEDV,LVEF combined detection for diagnosing CHD was 0.962,sensitivity was 92.41%and specificity was 83.33%.AUC of quad-detection was significantly higher than those of single detections(P<0.05 or<0.01).Conclusion:LVEDd,LVESV,LVEDV and LVEF a

关 键 词：冠心病 超声心电描记术 冠状动脉狭窄 

分 类 号：R541.409[医药卫生—心血管疾病]