心脏超声联合血细胞参数对高原人员心脏改变的诊断价值  

Diagnostic value of cardiac ultrasound combined with blood cell parameters forcardiac changes of people in plateau regions

作　　者：荣坤 王铮 郑红霞 RONG Kun;WANG Zheng;ZHENG Hongxia(Department of Ultrasound,Qingdao Special Service Recuperation Center of the Chinese People's Liberation Army Navy,Qingdao 266000,China;The First Affi liated Clinical Medical College of Qingdao University Medical College,Qingdao 266000,China;Department of Clinical Laboratory,Qingdao Special Service Recuperation Center of the Chinese People's Liberation Army Navy,Qingdao 266000,China)

机构地区：[1]海军青岛特勤疗养中心超声诊断科,山东青岛266000 [2]青岛大学医学部附属第一临床医学院,山东青岛266000 [3]海军青岛特勤疗养中心检验科,山东青岛266000

出　　处：《长春中医药大学学报》2024年第9期1028-1032,共5页Journal of Changchun University of Chinese Medicine

基　　金：军队后勤科研立项项目(CKJ17J018)。

摘　　要：目的 探讨心脏超声联合血细胞相关参数对高原人员心脏改变的诊断价值。方法 选择2020年12月-2022年12月来海军青岛特勤疗养中心疗养的高原地区人员(海拔>3 000 m,生活2个月以上)210例作为研究对象,根据心脏是否发生改变分为心脏改变组(70例)和对照组(140例)。进行心脏超声检查、血液分析。比较2组临床资料;采用Logistic多因素回归分析法明确影响高原人员心脏改变的危险因素;绘制受试者工作特征曲线(ROC curve)评估心脏超声联合血细胞相关参数对高原地区人员心脏改变的诊断价值。结果 与对照组比较,心脏改变组血细胞参数中血红蛋白(Hb)、血细胞比容(HCT)、红细胞分布宽度变异系数(RDW-CV)、白细胞计数(WBC)水平高,右 心 房 内 径(RAD)及右心室内径(RVD)增加比例明显升高,组间差异均具有统计学意义(P<0.05);Logistic多因素回归分析结果显示,RAD、RVD、Hb、RDW-CV是影响高原心脏改变的的危险因素;心脏超声联合血液参数诊断高原地区人员心脏改变的敏感度、准确度、曲线下面积(AUC)分别为90.12%、89.36%、0.908,均高于心脏超声、血液相关参数的独立诊断。结论 高原地区人员心脏改变以三尖瓣反流及右心房、右心室内径增加为主,心脏超声联合血细胞相关参数诊断高原人员心脏改变的效能高于二者的独立诊断。Objective To explore the diagnostic value of cardiac ultrasound combined with blood cell parameters for cardiac changes of people in plateau regions.Methods A total of 210 people from plateau regions(over 3000 meters above sea level,living for more than 2 months)who came to Qingdao Special Service Recuperation Center of the Chinese People's Liberation Army Navy for recuperation from December 2020 to December 2022 were selected as the research subjects and divided into the cardiac change group(n=70)and the control group(n=140)according to whether there were changes in the heart.Cardiac ultrasound examination and blood analysis were performed.The risk factors aff ecting the heart changes of people in plateau regions were identifi ed by Logistic multivariate regression analysis.Receiver operator characteristic curve(ROC curve)was plotted to evaluate the diagnostic value of cardiac ultrasound combined with blood cell related parameters for cardiac changes of people in plateau regions. ResultsCompared with the control group, hemoglobin (Hb) level, hematocrit (HCT), red blood cell distribution width coefficient ofvariation (RDW-CV), and white blood cell count (WBC) in the cardiac change group were higher, the proportion of right atriumdiameter (RAD) and right ventricle diameter (RVD) increased significantly, and there was statistically significant differencebetween groups (P <0.05). Logistic multivariate regression analysis showed that RAD, RVD, Hb and RDW-CV were the riskfactors aff ecting cardiac changes of people in plateau regions. The sensitivity, accuracy, and area under the curve (AUC) of cardiacultrasound combined with blood parameters in the diagnosis of cardiac changes of people in plateau regions were 90.12%, 89.36%,and 0.908, respectively, which was higher than the independent diagnosis of cardiac ultrasound and blood cell related parameters.Conclusion The cardiac changes of the people in plateau regions are mainly characterized by tricuspid regurgitation and increasedRAD and RVD. The effi cacy of cardiac u

关 键 词：心脏病变 血细胞参数 心脏超声 诊断价值 

分 类 号：R541[医药卫生—心血管疾病]