超声心肌灌注评分在原发性高血压患者早期心脏靶器官损害中的评估价值  

Evaluation Value of Ultrasonic Myocardial Perfusion Score in Early Cardiac Target Organ Damage in Patients with Essential Hypertension

作　　者：崔丽鹏 CUI Lipeng(Department of Ultrasound,Zhengzhou Yangcheng Hospital,Zhengzhou 452470,China)

机构地区：[1]郑州阳城医院超声科,河南郑州452470

出　　处：《航空航天医学杂志》2024年第11期1287-1290,共4页Journal of Aerospace medicine

摘　　要：目的探讨超声心肌灌注评分在原发性高血压患者早期心脏靶器官损害中的评估价值。方法回顾性选取本院2022年02月~2024年05月收治的94例原发性高血压患者的临床资料。所有患者入院后均完成心脏学超声学造影检查。根据超声学造影下测得的左室射血分数(LVEF)将患者分为未降组和降低组。分析对比两组的超声心动图结果[二尖瓣EDT、二尖瓣平均Em、二尖瓣E/Em]、超声造影结果[左心室长轴应变(GLS)、室壁运动积分指数(WMSI)、心肌灌注积分指数(CSI)、心肌灌注异常、罪犯血管],分析各超声指标对左室射血分数下降的诊断价值。结果LVEF下降组的二尖瓣EDT、二尖瓣平均Em均低于未降组,LVEF下降组二尖瓣E/Em显著高于未降组(P<0.05)。LVEF下降组的GLS显著低于未降组,LVEF下降组的WMSI、CSI均显著高于未降组(P<0.05)。LVEF下降组的心肌灌注异常占比显著高于未降组(P<0.05);LVEF下降组的罪犯血管前降支占比显著高于未降组(P<0.05)。ROC曲线分析显示:GLS、WMSI、CSI、二尖瓣EDT、二尖瓣平均Em、二尖瓣E/Em的曲线下面积分别为0.793(95%CI:0.700~0.886)、0.812(95%CI:0.713~0.910)、0.748(95%CI:0.645~0.851)、0.758(95%CI:0.656~0.860)、0.649(95%CI:0.533~0.764)、0.787(95%CI:0.683~0.891),特异度分别为82.5%、87.7%、84.2%、87.7%、73.7%、80.7%,灵敏度分别为67.6%、73.0%、56.8%、56.8%、48.6%、75.7%。结论原发性高血压患者发生LVEF降低时心肌功能显著下降,而心肌灌注评分对原发性高血压心肌功能具有一定预测价值。Objective To evaluate the value of ultrasonic myocardial perfusion score in early cardiac target organ damage in patients with essential hypertension.Methods The clinical data of 94 patients with essential hypertension admitted to our hospital from February 2022 to May 2024 were retrospectively selected.All patients underwent cardiac echocardiography after admission.According to the left ventricular ejection fraction(LVEF)measured by contrast-enhanced ultrasonography,the patients were divided into non-decreasing group and decreasing group.The echocardiographic results[mitral valve EDT,mean mitral valve Em,mitral valve E/Em],contrast-enhanced ultrasound results[left ventricular major axis strain(GLS),ventricular wall motion integral index(WMSI),myocardial perfusion integral index(CSI),abnormal myocardial perfusion,and criminal vessels]of the two groups were analyzed and compared.To analyze the diagnostic value of each ultrasonic index in the decrease of left ventricular ejection fraction.Results The mitral valve EDT and mean mitral valve Em in the LVEF decreasing group were lower than those in the non-decreasing group,and the mitral valve E/Em in the LVEF decreasing group was significantly higher than that in the non-decreasing group(P<0.05).GLS in LVEF decreasing group was significantly lower than that in non-decreasing group,WMSI and CSI in LVEF decreasing group were significantly higher than those in non-decreasing group(P<0.05).The proportion of abnormal myocardial perfusion in the decreased LVEF group was significantly higher than that in the non-decreased group(P<0.05).The proportion of anterior descending vessels in the decreasing group of LVEF was significantly higher than that in the non-decreasing group(P<0.05).ROC curve analysis showed that the area under the curve of GLS,WMSI,CSI,mitral valve EDT,mean mitral valve Em and mitral valve E/Em were 0.793(95%CI:0.7700~0.886),0.812(95%CI:0.713~0.910)and 0.748(95%CI:0.713~0.910),respectively.(0.645~0.851),0.758(95%CI:0.656~0.860),0.649(95%CI:0.533~0.764),0.787

关 键 词：心脏学造影 心肌灌注 原发性高血压 心脏靶器官损害 

分 类 号：R544.1[医药卫生—心血管疾病]