二维超声心动图联合彩色多普勒血流成像在肥厚型心肌病诊断中的价值分析  

Analysis on the value of 2DE combined with CDFI in diagnosing HCM

作　　者：张喻 安培莉 王宁 钟淑娟 Zhang Yu;An Peili;Wang Ning;Zhong Shujuan(Department of Ultrasonography,Northwest Women's and Children's Hospital,Xi'an 710003,China)

机构地区：[1]西北妇女儿童医院超声科,西安710003

出　　处：《中国医学装备》2024年第5期83-87,共5页China Medical Equipment

基　　金：陕西省重点研发计划(2019SF-064)。

摘　　要：目的:观察二维超声心动图(2DE)联合彩色多普勒血流成像(CDFI)在肥厚型心肌病(HCM)诊断中的价值。方法:选择2019年1月至2021年1月期间西北妇女儿童医院收治的480例HCM患者,将其纳入病例组,选取同期进行健康体检的200名体检者纳入健康对照组,所有受试者均行2DE和CDFI检查,统计并比较两组2DE、CDFI检测指标,分析2DE、CDFI单独及联合诊断的效能。结果:病例组患者左心室后壁厚度(LVPW)、室间隔厚度(IVST)及左心房内径(LAD)均高于健康对照组,差异均具有统计学意义(t=5.896、14.861、8.974,P<0.05)。病例组患者的二尖瓣前向血流E峰与A峰比值(E/A)、二尖瓣环舒张早期运动速度(Em)均低于对照组,二尖瓣口舒张早期血流速度(E)与Em比值(E/Em)高于健康对照组,差异均具有统计学意义(t=6.782、5.189、10.738,P<0.05)。2DE、CDFI单独及联合诊断HCM的受试者工作特征(ROC)曲线最优临界点(检测灵敏度)分别为67.83%、65.38%和82.38%,检测特异度分别为65.48%,64.58%和80.66%,其ROC曲线下面积分别为0.6835、0.6949和0.8136,准确率分别为68.35%、69.49%和81.36%,95%置信区间分别为0.608~0.803、0.606~0.823和0.835~0.943,2DE联合CDFI诊断HCM的灵敏度、特异度及准确率均高于2DE、CDFI单独诊断。结论:2DE和CDFI在HCM诊断中均具有一定价值,但二者联合可进一步提高HCM的诊断效能。Objective:To observe the value of two-dimensional echocardiography(2DE)combined with color Doppler flow imaging(CDFI)in the diagnosis for hypertrophic cardiomyopathy(HCM).Methods:A total of 480 HCM patients who admitted to Northwest Women's and Children's Hospital from January 2019 to January 2021 were selected as case group,and 200 healthy individuals who underwent health physical examination were included into health control group.All receivers underwent 2DE and CDFI examinations,and the 2DE and CDFI detection indicators of two groups were calculated by statistical method and were compared.The diagnostic efficacies of single 2DE,single CDFI and the combination of them were analyzed.Results:The thickness of left ventricular posterior wall(LVPW),interventricular septum thickness(IVST)and left atrial diameter(LAD)of the case group were significantly higher than those of the control group,and the differences were statistically significant(t=5.896,14.861,8.974,P<0.05),respectively.The E peak/A peak(E/A)of anterior flow of mitral valve and early diastolic velocity of mitral valve(Em)of the case group were respectively lower than those of the health control group,while the early diastolic blood flow velocity of mitral valve opening(E)/Em(E/Em)of the case group was higher than that of the health control group,with statistically significant differences(t=6.782,5.189,10.738,P<0.05).The optimal critical points(detection sensitivity)of the receiver operating characteristic(ROC)curves of single 2DE,single CDFI and combination of them in diagnosing HCM were respectively 67.83%,65.38%and 82.38%.The detection specificities of them were respectively 65.48%,64.58%and 80.66%.The area under curve(AUC)values of ROC curves of them were respectively 0.6835,0.6949 and 0.8136,and the accuracies of them were respectively 68.35%,69.49%and 81.36%,and the 95%confidence intervals of them were respectively 0.608-0.803,0.606-0.823 and 0.835-0.943.The sensitivity,specificity and accuracy of the combination of 2DE and CDFI were respectively hig

关 键 词：二维超声心动图(2DE) 彩色多普勒血流成像(CDFI) 室间隔肥厚型心肌病(HCM) 诊断价值 

分 类 号：R445.1[医药卫生—影像医学与核医学]