颈动脉超声联合心脏超声对冠心病患者不良预后的评估价值  

Assessed value of carotid artery ultrasonography combined with cardiac ultrasonography to poor prognosis in patients with coronary heart disease

作　　者：张尤佳 王焕勇[2] 高明杰 刘宇毅[1] 姜霄鹰[1] 朱芙丽[3] 彭如臣[2] Zhang Youjia;Wang Huanyong;Gao Mingjie;Liu Yuyi;Jiang Xiaoying;Zhu Fuli;Peng Ruchen(Department of Ultrasonography,Beijing Luhe Hospital,Capital Medical University,Beijing 101149,China;不详)

机构地区：[1]首都医科大学附属北京潞河医院超声科,北京101149 [2]首都医科大学附属北京潞河医院医学影像科,北京101149 [3]首都医科大学附属北京潞河医院心内科,北京101149

出　　处：《中国循证心血管医学杂志》2024年第5期607-610,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨颈动脉超声联合心脏超声对冠状动脉粥样硬化性心脏病(冠心病)患者不良预后的评估价值。方法选择2022年5月至2023年10月于首都医科大学附属北京潞河医院收治的125例冠心病患者作为研究对象,根据是否发生不良心血管事件进行预后评估,分为预后良好组(n=92)、预后不良组(n=33);两组均行颈动脉超声与心脏超声,对比其检查参数(颈动脉内-中膜厚度与E峰峰速、A峰峰速、左室射血分数、左室舒张末内径)以及颈动脉情况、左心室舒张功能等。运用Logistic回归分析法分析不良预后的影响因素;采用Kappa一致性检验,分析颈动脉超声、心脏超声单独及二者联合对不良预后评估的准确性。结果预后不良组颈动脉内-中膜厚度、左室舒张末内径大于预后良好组,A峰峰速、左室射血分数小于预后良好组(P<0.05);两组E峰峰速比较,P>0.05。预后不良组颈动脉病变、左心室舒张功能障碍检出率高于预后良好组(P<0.05)。Logistic回归分析显示:颈动脉病变、左心室舒张功能障碍均是冠心病患者不良预后的危险因素。Kappa一致性检验结果显示:颈动脉超声检查对不良预后评估的一致性一般(Kappa=0.395),心脏超声对不良预后评估的一致性差(Kappa=0.466),二者联合对不良预后的评估一致性较好(Kappa=0.679)。结论颈动脉超声联合心脏超声对冠心病患者不良预后的评估具有较好的应用价值,值得临床应用。Objective To discuss the assessed value of carotid artery ultrasonography combined with cardiac ultrasonography to poor prognosis in patients with coronary heart disease(CHD).Methods CHD patients(n=125)were chosen from Beijing Luhe Hospital affiliated to Capital Medical University from May 2022 to Oct.2023.The patients were divided,according to prognosis reviewing based on occurrence of adverse cardiovascular events,into good prognosis group(n=92)and poor prognosis group(n=33).All groups were given examinations of carotid artery ultrasonography and cardiac ultrasonography,and parameters[carotid artery intima-media thickness(CAIMT),E-peak velocity,A-peak velocity,left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDd)and carotid artery condition and left ventricular diastolic function]were compared between 2 groups.The influence factors of poor prognosis were analyzed by using Logistic regression analysis.The accuracy of carotid artery ultrasonography,cardiac ultrasonography and combination of both in reviewing poor prognosis was analyzed by using Kappa consistency test.Results The indexes of CA-IMT and LVEDd were higher,and indexes of A-peak velocity and LVEF were lower in poor prognosis group than those in good prognosis group(P<0.05).The comparison in index of E-peak velocity showed(P>0.05)between 2 groups.The detection rates of carotid artery lesion and left ventricular diastolic dysfunction(LVDD)were higher in poor prognosis group than those in good prognosis group(P<0.05).The results of Logistic regression analysis showed that carotid artery lesion and LVDD were risk factors of poor prognosis in CHD patients.The results of Kappa consistency test showed that,in reviewing poor prognosis,consistency of carotid artery ultrasonography was general(Kappa=0.395),consistency of cardiac ultrasonography was poor(Kappa=0.466)and consistency of carotid artery ultrasonography combined with cardiac ultrasonography was good(Kappa=0.679).Conclusion The application value of carotid artery ultra

关 键 词：颈动脉超声 心脏超声 冠心病 不良预后 

分 类 号：R541.4[医药卫生—心血管疾病]