缺血性心肌病经皮冠状动脉介入术后心脏超声与主要不良心血管事件的关系研究  

Study on the relationship between cardiac ultrasound and major adverse cardiovascular events after PCI in ischemic cardiomyopathy

作　　者：王曼 赵森[1] Wang Man;Zhao Sen(Department of Medical Imaging,the First Affiliated Hospital of Henan University,Kaifeng475000,China)

机构地区：[1]河南大学第一附属医院医学影像科,开封475000

出　　处：《实用医技杂志》2024年第2期90-94,共5页Journal of Practical Medical Techniques

基　　金：河南省医学科技攻关计划(LH-GJ20210565)。

摘　　要：目的分析缺血性心肌病(ICM)经皮冠状动脉介入术(PCI)后心脏超声与主要不良心血管事件(MACE)的关系。方法回顾性分析本院2020年10月至2022年10月住院的80例接受PCI手术治疗的ICM患者,根据术后1年是否发生MACE将其分为2组,将18例发生MACE的患者设为观察组,62例未发生MACE的患者设为对照组,比较2组心脏超声指标,单因素、多因素Logistic回归分析ICM患者PCI术后MACE的危险因素,通过受试者工作特征曲线(ROC)分析心脏超声对ICM患者PCI术后MACE的预测效能。结果观察组左室射血分数(LVEF)、二尖瓣血流频谱E峰/A峰(E/A)均低于对照组(P<0.05),观察组左室舒张末期内径(LVEDD)高于对照组(P<0.05)。年龄、糖尿病病史、PCI术后复流、C反应蛋白(CRP)是ICM患者PCI术后MACE发生的危险因素(P<0.05)。LVEF、LVEDD、E/A联合检测预测ICM患者PCI术后MACE的曲线下面积(AUC)(95%CI):0.851(0.828,0.958),LVEF、LVEDD、E/A联合检测预测灵敏度(94.1%)高于单一检测(73.5%、69.8%、78.9%)(P<0.05),LVEF、LVEDD、E/A联合检测特异度(84.1%)与单一检测(79.2%、76.0%、80.1%)比较差异无统计学意义(P>0.05)。结论ICM患者PCI术后MACE的发生与多种因素有关,联合检测LVEF、LVEDD、E/A可提高对MACE的预测效能,具有重要的参考价值。Objective To analyze the relationship between cardiac ultrasound and major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI)in ischemic cardiomyopathy(ICM).Methods Eighty patients with ICM who received PCI treatment in our hospital from October 2020 to October 2022 were selected and divided into two groups according to whether MACE occurred one year after surgery.Eighteen patients with MACE were set as the observation group and 62 patients without MACE were set as the control group.Cardiac ultrasound indexes of the two groups were compared.The risk factors of MACE after PCI in ICM patients were analyzed by univariate and multivariate logistic regression,and the predictive efficacy of cardiac ultrasound for MACE after PCI in ICM patients was analyzed by receiver operating curve(ROC).Results Left ventricular ejection fraction(LVEF)and mitral valve flow spectrum peak E/A(E/A)in observation group were lower than those in control group(P<0.05),and left ventricular end-diastolic diameter(LVEDD)in observation group was higher than that in control group(P<0.05).Age,diabetes,relapse after PCI and C-reactive protein(CRP)were the risk factors for MACE after PCI in ICM patients(P<0.05).The combined detection of LVEF,LVEDD,and E/A predicted the area under the curve(AUC)of MACE in ICM patients after PCI was 0.851,and the 95%CI confidence interval was(0.828,0.958).The prediction sensitivity of LVEF,LVEDD and E/A combined detection(94.1%)was higher than that of single detection(73.5%,69.8%,78.9%)(P<0.05).The specificity of LVEF,LVEDD and E/A combined detection(84.1%)was compared with that of single detection(79.2%,76.0%,80.1%)(P>0.05).Conclusion The occurrence of MACE in ICM patients after PCI is related to many factors,and the combined detection of LVEF,LVEDD and E/A can improve the prediction efficiency of MACE,which has important reference value.

关 键 词：心肌病 缺血性 经皮冠状动脉介入治疗 超声心动描记术 不良事件 

分 类 号：R541.4[医药卫生—心血管疾病]