心脏彩色多普勒超声对左室肥厚伴左心衰竭的诊断价值  

Diagnostic value of cardiac color Doppler ultrasound for left ventricular hypertrophy complicated left heart failure

作　　者：吕群星 张松美 林鹏生 陈坛寿 LYU Qun-xing;ZHANG Song-mei;LIN Peng-sheng;CHEN Tan-shou(Department of Ultrasound,Ningde City Hospital Affiliated to Ningde Normal College,Ningde,Fujian,352100,China)

机构地区：[1]宁德师范学院附属宁德市医院超声科,福建宁德352100

出　　处：《心血管康复医学杂志》2025年第2期184-189,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨心脏彩色多普勒超声对左室肥厚(LVH)伴左心衰竭(LHF)的诊断价值。方法:选择2019年1月至2023年1月宁德师范学院附属宁德市医院收治的117例LVH伴LHF患者(心衰组),以及同期在我院行一般体检的100名健康对象(对照组)进行研究。采用心脏彩色多普勒超声检测两组左心室射血分数(LVEF)、左房内径(LAD)、左心室舒张末期内径(LVEDd)、舒张早期流速峰值/舒张晚期流速峰值(E/A);受试者工作特征曲线(ROC)分析心脏彩超中各指标对LVH伴LHF的诊断价值;另将117例LVH伴LHF患者按照心功能分级不同分为轻度组(n=54)与中重度组(n=63),采用Spearman法分析心脏彩超各参数与心功能分级的相关性。结果:与对照组相比,心衰组LVEF[(47.88±4.75)%比(69.81±5.64)%]显著降低,LAD[(44.03±4.88)mm比(27.56±2.76)mm]、LVEDd[(55.68±5.04)mm比(42.19±1.38)mm]、E/A[(13.04±3.58)比(6.60±1.67)]均显著增加(P均<0.001)。ROC分析显示,心脏彩超各参数联合检测对LVH伴LHF的诊断价值要显著高于单一检测(联合检测:AUC=0.901,95%CI 0.853~0.937;LVEF:AUC=0.644,95%CI 0.577~0.708;LAD:AUC=0.703,95%CI 0.637~0.763;LVEDd:AUC=0.633,95%CI 0.565~0.697;E/A:AUC=0.748,95%CI 0.685~0.804,Z=7.062、5.764、7.292、4.864,P均<0.001)。与轻度组比较,中重度组患者LVEF[(45.67±3.37)%比(50.47±4.86)%]显著更低,LAD[(46.31±4.42)mm比(41.36±3.98)mm]、LVEDd[(60.09±1.75)mm比(50.53±1.41)mm]、E/A[(13.99±2.96)比(11.93±3.92)]显著更高(P均<0.01);Spearman相关分析显示LVEF与心功能分级之间呈显著负相关(r=-0.474),LAD(r=0.511)、LVEDd(r=0.863)、E/A(r=0.269)则与心功能分级之间呈显著正相关(P均<0.01)。结论:心脏彩色多普勒超声能较好地诊断LVH伴LHF,同时还能够有效预测LVH伴LHF患者的心功能。Objective:To explore the diagnostic value of cardiac color Doppler ultrasonography for left ventricular hypertrophy(LVH)complicated left heart failure(LHF).Methods:A total of 117 LVH patients complicated LHF admitted in Ningde City Hospital Affiliated to Ningde Normal College between January 2019 and January 2023(heart failure group)and 100 healthy people(control group)who underwent general physical examination in our hospital simultaneously were selected for the study.Left ventricular ejection fraction(LVEF),left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDd),early diastolic peak flow velocity/late diastolic peak flow velocity(E/A)were measured by cardiac color Doppler ultrasound in two groups.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of cardiac color Doppler ultrasound indexes for LVH complicated LHF.In addition,the 117 patients with LVH and LHF were divided into mild group(n=54)and moderate to severe group(n=63)according to cardiac function class.Spearman correlation analysis was used to analyze the associationof cardiac color ultrasound parameters with cardiac function class.Results:Compared with participants in control group,those in heart failure group had significant lower LVEF[(47.88±4.75)%vs.(69.81±5.64)%],and significant higher LAD[(44.03±4.88)mm vs.(27.56±2.76)mm vs.],LVEDd[(55.68±5.04)mm vs.(42.19±1.38)mm],E/A[(13.04±3.58)vs.(6.60±1.67)](P<0.001 all).ROC analysis indicated that the area under the curve(AUC)of the combination of various parameters of cardiac ultrasound for diagnosing LVH with LHF was significantly higher than those of the single tests(Combined detection:AUC=0.901,95%CI 0.853~0.937 vs LVEF:AUC=0.644,95%CI 0.577~0.708,LAD:AUC=0.703,95%CI 0.637~0.763,LVEDd:AUC=0.633,95%CI 0.565~0.697,E/A:AUC=0.748,95%CI 0.685~0.804,Z=7.062,5.764,7.292,4.864,P<0.001 all).Compared with patients in mild group,those in moderate to severe group had significant lower LVEF[(45.67±3.37)%vs.(50.47±4.86)%],and significant higher LAD[(46.31±4

关 键 词：心力衰竭 肥大 左心室 超声检查 多普勒 彩色 

分 类 号：R541.61[医药卫生—心血管疾病]