三维超声心动图参数在二尖瓣关闭不全中的诊断价值研究  

Diagnostic value of 3D echocardiography in mitral insufficiency

作　　者：张虎 侯永波 王柱 周中新 王国祥 Zhang Hu;Hou Yongbo;Wang Zhu;Zhou Zhongxin;Wang Guoxiang(Department of Cardiac Vascular Surgery,The Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)

机构地区：[1]徐州医科大学附属医院心脏大血管外科,徐州221000

出　　处：《中国医学装备》2024年第12期93-97,共5页China Medical Equipment

基　　金：江苏省妇幼科研项目(JS202123)。

摘　　要：目的:探究三维超声心动图参数在二尖瓣关闭不全(MI)中的应用价值。方法:选取2023年1月至2023年11月徐州医科大学附属医院收治的180例MI患者,根据MI严重程度将其分为重度组(130例)和轻度组(50例)。两组均给予常规超声心动图及三维超声心动图检查,比较不同超声心动图参数,分析超声心动图对MI患者左室构型和收缩功能的诊断效能。结果:重度组患者的心率、心动图QRS间期高于轻度组,差异有统计学意义(t=3.910、6.336,P<0.05),左室舒张末期内径(LVEDD)、LVEDD指数、左心室(LV)长度、LV长度指数、左室舒张末期容积(LVEDV)、LVEDV指数、收缩末期容积(LVESV)、LVESV指数、LV质量指数(LVMI)、相对后壁厚度(RWT)以及二维超声心动图球形指数(2D-SI)均高于轻度组,差异有统计学意义(t=27.729、14.509、11.745、8.182、24.171、32.989、25.988、20.994、22.707、6.331、20.603,P<0.05)。重度组的三维左室射血分数(3D-LVEF)低于轻度组,三维舒张末期血流速度(3D-EDV)、3D-EDV指数及三维超声心动图球形指数(3D-SI)均高于轻度组,差异有统计学意义(t=2.855、24.320、10.409、36.056,P<0.05)。受试者工作特征(ROC)曲线结果显示,LVEDD指数、LVEDV指数、LVESV指数、3D-LVEF、3D-EDV指数以及3D-SI诊断MI的灵敏度分别为70.83%、68.47%、81.25%、71.58%、72.42%和90.38%,特异度分别为67.40%、65.06%、79.64%、68.10%、71.68%和90.38%,ROC曲线下面积(AUC)值分别为0.658、0.612、0.814、0.726、0.799和0.852。3D-SI诊断MI左室重构的灵敏度和特异度最高。结论:三维超声心动图在MI中的应用价值较高,能够反映LV的重构和收缩功能,其中3D-SI能够较好描述患者的LV重构,可为临床观察MI的研究进展提供参考。Objective:To explore application value of three-dimensional(3D)echocardiography in mitral insufficiency(MI).Methods:A total of 180 MI patients who admitted to The Affiliated Hospital of Xuzhou Medical University from January 2023 to November 2023 were selected,and they were divided into a severe group(n=130)and a mild group(n=50)based on the MI severity.Both groups received routine echocardiography and 3D echocardiography to compare the parameters of routine echocardiography,and analyze the diagnostic efficacy of echocardiography for left ventricular configuration and systolic function in MI patients.Results:The heart rate and QRS interval of patients in the severe group were respectively higher than those in the mild group(t=3.910,6.336,P<0.05),respectively.The left ventricular end diastolic diameter(LVEDD),LVEDD index,left ventricular(LV)length,LV length index,left ventricular end diastolic volume(LVEDV),LVEDV index,left ventricular end systolic volume(LVESV),LVESV index,LV mass index(LVMI),relative wall thickness(RWT),and two-dimensional echocardiogram sphericity index(2D-SI)in the severe group were all higher than those in the mild group(t=27.729,14.509,11.745,8.182,24.171,32.989,25.988,20.994,22.707,6.331,20.603,P<0.05).The three-dimensional left ventricular ejection fraction(3D-LVEF)of the severe group was lower than that of the mild group,and the three-dimensional end diastolic velocity(3D-EDV)of blood flow,3D-EDV index,and three-dimensional echocardiogram sphericity index(3D-SI)of the severe group were all higher than those of the mild group(t=2.855,24.320,10.409,36.056,P<0.05).The results of receiver operating characteristic(ROC)curve showed that the sensitivities of LVEDD index,LVEDV index,LVESV index,3D-LVEF,3D-EDV index,and 3D-SI were respectively 70.83%,68.47%,81.25%,71.58%,72.42%and 90.38%in diagnosing MI.The specificities of them were respectively 67.40%,65.06%,79.64%,68.10%,71.68%and 90.38%.The area under curve(AUC)values of the ROC curve were respectively 0.658,0.612,0.814,0.726,0.799 and 0.852.3

关 键 词：二尖瓣关闭不全(MI) 三维超声心动图 左室构型 收缩功能 

分 类 号：R445.1[医药卫生—影像医学与核医学]