心脏彩色多普勒超声在老年糖尿病患者中筛查心房颤动的应用  

Application of echocardiography in screening for atrial fibrillation in elderly diabetic patients

作　　者：李俊鹏[1,3] 吕精巧[2] 杨高乐 解娜[4] 孙永琨[5] LI Junpeng;LYU Jingqiao;YANG Gaole;XIE Na;SUN Yongkun(Ultrasound Medicine Department and Health Management Center of the Third Affiliated Hospital of Xinxiang Medical College,Xinxiang 453000,China;Nursing Department of the Third Affiliated Hospital of Xinxiang Medical College,Xinxiang 453000,China;Health Management Center of the Third Affiliated Hospital of Xinxiang Medical College,Xinxiang 453000,China;Xinxiang Medical College Third Affiliated Department of Cardiology,Xinxiang 453000,China;Teaching and Experimental Center of the Basic College of Xinxiang Medical College,Xinxiang 453000,China)

机构地区：[1]新乡医学院第三附属医院超声医学科,河南新乡453000 [2]新乡医学院第三附属医院护理部,河南新乡453000 [3]新乡医学院第三附属医院健康管理中心,河南新乡453000 [4]新乡医学院第三附属医院心内科,河南新乡453000 [5]新乡医学院基础学院教学实验中心,河南新乡453000

出　　处：《医学影像学杂志》2024年第12期52-56,共5页Journal of Medical Imaging

基　　金：河南省医学教育研究项目(编号:Wjlx2020426);新乡医学院第三附属医院开放课题(编号:KFKTYB202123)。

摘　　要：目的观察心脏彩色多普勒超声在老年糖尿病患者中筛查心房颤动的应用价值。方法选取本院收治的老年糖尿病患者228例,根据是否合并心房颤动分为心房颤动组、无心房颤动组。比较两组一般资料及心脏彩色多普勒超声参数;用Logistic回归模型分析老年糖尿病患者发生心房颤动的影响因素;绘制受试者工作特征曲线(ROC)分析心脏彩色多普勒超声参数对老年糖尿病患者发生心房颤动的诊断价值。结果228例患者心房颤动发生率22.37%;心房颤动组左心房内径(LAD)、左心房容积(LAV)、左心房容积指数(LAVI)、二尖瓣舒张早期血流速度峰值与舒张晚期血流速度峰值(E/A)比值高于无心房颤动组,左心室射血分数(LVEF)低于无心房颤动组,差异有统计学意义(P<0.05);Logistic回归模型分析显示,年龄、糖化血红蛋白(HbAlc)、LAD、LVEF、E/A比值是老年糖尿病患者发生心房颤动的影响因素(P<0.05);ROC曲线显示,LAD、LVEF、E/A比值联合诊断老年糖尿病患者心房颤动的灵敏度高于单独诊断,曲线下面积(AUC)也高于单独诊断,差异有统计学意义(Z=3.165,P=0.002;Z=2.872,P=0.004;Z=3.385,P<0.001),特异度与单独诊断基本一致。结论年龄、HbAlc及心脏彩色多普勒超声参数LAD、LVEF、E/A比值是老年糖尿病患者发生心房颤动的影响因素,LAD、LVEF、E/A比值联合对心房颤动具有较高的诊断价值。Objective To observe the value of echocardiography in screening for atrial fibrillation in elderly diabetic patients.Methods Two hundred twenty-eight elderly patients with diabetes admitted to our hospital were divided into atrial fibrillation group and non-atrial fibrillation group according to whether they were complicated with atrial fibrillation.The general data and echocardiographic parameters were compared between the two groups.Logistic regression model was used to analyze the influencing factors of atrial fibrillation in elderly diabetic patients.Receiver operating characteristic curve(ROC)was drawn to analyze the diagnostic value of echocardiographic parameters for atrial fibrillation in elderly diabetic patients.Results The incidence of atrial fibrillation in 228 patients was 22.37%.Left atrial diameter(LAD),left atrial volume(LAV),left atrial volume index(LAVI),and the ratio of peak velocity of early diastolic filling to peak velocity of late diastolic filling across the mitral valve(E/A)ratios in atrial fibrillation group were higher than those in non-atrial fibrillation group,left ventricular ejection fraction(LVEF)was lower than that in non-atrial fibrillation group(P<0.05).Logistic regression model analysis showed that age,hemoglobin Alc(HbAlc),LAD,LVEF,and E/A ratio were influencing factors of atrial fibrillation in elderly diabetic patients(P<0.05).ROC curve showed that the combination of LAD,LVEF,and E/A ratio had higher sensitivity than single diagnosis for atrial fibrillation in elderly diabetic patients,and the area under the curve(AUC)was also higher than single diagnosis(Z=3.165,P=0.002,Z=2.872,P=0.004,Z=3.385,P<0.001),and the specificity was similar to single diagnosis.Conclusion Age,HbAlc,and echocardiographic parameters LAD,LVEF,and E/A ratio are influencing factors of atrial fibrillation in elderly diabetic patients,and the combination of LAD,LVEF,and E/A ratio has high diagnostic value for atrial fibrillation.

关 键 词：心脏彩色多普勒超声 糖尿病 心房颤动 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R587.1[医药卫生—诊断学]