经胸彩色多普勒超声心动图对高血压房颤患者心脏功能及结构变化的评估价值  

Assessment value of transthoracic color Doppler echocardiography for the changes of cardiac function and structure of patients with hypertensive atrial fibrillation

作　　者：刘祥蓉 周恕敏 徐岩鹰 廖晓红[3] LIU Xiang-rong;ZHOU Shu-min;XU Yanying(Department of Ultrasound Medicine,Jianyang Traditional Chinese Medicine Hospital,Jianyang 641400,China;不详)

机构地区：[1]简阳市中医医院超声医学科,四川简阳641400 [2]简阳市中医医院心内科,四川简阳641400 [3]简阳市人民医院超声科,四川简阳641400

出　　处：《中国医学装备》2023年第8期66-70,共5页China Medical Equipment

基　　金：四川省医学重点学科(实验室)及重点专科建设项目(20PJ311)“心脏彩色多普勒超声检查在诊断高血压性心脏病中的应用价值”。

摘　　要：目的:探讨经胸彩色多普勒超声心动图对高血压房颤患者心脏功能及结构变化的评估价值。方法:选取医院收治的99例原发性高血压患者,根据是否合并房颤将其分为单纯高血压组(59例)和房颤组(40例),所有患者均行经胸彩色多普勒超声心动图检查,比较两组患者临床资料及心脏超声指标差异;采用受试者工作特征(ROC)曲线分析超声指标预测高血压患者并发房颤的价值。结果:房颤组男性占比高于单纯高血压组(x^(2)=4.927,P<0.05),病程、收缩压、舒张压及体质量指数(BMI)均高于单纯高血压组(t=6.957,t=6.796,t=4.961,t=6.996;P<0.05),室间隔厚度(IVSd)、左室舒张末期内径(LVIDd)、左室后壁厚度(LVPWd)、室间隔收缩末期厚度(IVSs)、室间隔舒张末期厚度(IVSTd)、左室收缩末期内径(LVIDs)、左室后壁收缩期厚度(LVPWs)、左室舒张末容积(EDV)及左室收缩末期容积(ESV)均高于单纯高血压组(t=2.701,t=2.737,t=3.307,t=2.957,t=2.926,t=3.054,t=3.140,t=2.973,t=3.756;P<0.05)。IVSd、LVPWd、LVIDd、IVSs、IVSTd、LVIDs、LVPWs、EDV及ESV预测房颤的ROC曲线下面积(AUC)分别为0.733、0.798、0.719、0.794、0.753、0.814、0.777、0.786及0.749,各项指标联合预测房颤的AUC为0.933,均有预测房颤的价值(Z=3.294,Z=3.084,Z=4.595,Z=4.186,Z=3.204,Z=4.395,Z=4.596,Z=5.304,Z=5.294,Z=7.697;P<0.05)。结论:高血压患者心脏结构变化以左心室结构改变为主,经胸彩色多普勒超声心动图对评估高血压并发房颤患者的心脏功能和结构变化有一定的临床价值。Objective:To explore the assessment value of transthoracic color Doppler echocardiography for the changes of cardiac function and structure of patients with hypertensive atrial fibrillation.Methods:A total of 99 patients with primary hypertension admitted to hospital were selected and they were divided into a simple hypertension group(59 cases)and an atrial fibrillation group(40 cases)based on whether they complicated with atrial fibrillation.All of patients underwent transthoracic color Doppler echocardiography.The differences of the clinical data and cardiac ultrasound indicators between the two groups were compared.The receiver operating characteristic(ROC)curve was adopted to analyze the value of ultrasound indicators in predicting the atrial fibrillation of patients with hypertension.Results:The proportion of male patients in the atrial fibrillation group was significantly higher than that in the simple hypertension group(x^(2)=4.927,P<0.05),and the course of disease,systolic blood pressure,diastolic blood pressure and body mass index(BMI)in the atrial fibrillation group were significantly higher than those in the simple hypertension group(t=6.957,t=6.796,t=4.961,t=6.996,P<0.05),respectively.The interventricular septum thickness(IVSd),left ventricular end diastolic diameter(LVIDd),left ventricular posterior wall thickness(LVPWd),interventricular septum end-systolic thickness(IVSs),interventricular septum thickness at end diastole(IVSTd),left ventricular end systolic diameter(LVIDs),left ventricular posterior wall systolic thickness(LVPWs),left ventricular end diastolic volume(EDV)and the left ventricular end systolic volume(ESV)of the atrial fibrillation group were significantly higher than those of the simple hypertension group(t=2.701,t=2.737,t=3.307,t=2.957,t=2.926,t=3.054,t=3.140,t=2.973,t=3.756,P<0.05),respectively.The ROC curves showed that the area under curves(AUCs)of IVSd,LVPWd,LVIDd,IVSs,IVSTd,LVIDs,LVPWs,EDV and ESV were respectively 0.733,0.798,0.719,0.794,0.753,0.814,0.777,0.786 and 0.749,and th

关 键 词：彩色多普勒超声心动图 高血压 房颤 心脏功能 心脏结构 

分 类 号：R445.1[医药卫生—影像医学与核医学]