左心房面积指数对左心室舒张功能不全的诊断价值

Value of left atria area index in diagnosis of left ventricular diastolic dysfunction

目的探讨左心房面积指数对高血压患者收缩功能正常的左心室舒张功能不全的诊断价值。方法选取2012年1月～2013年4月间海口市第四人民医院就诊的左心室收缩功能正常高血压患者173例,经常规超声心动图对以上患者左心房内径、左心房面积进行测量,并计算出其左心房内径指数及面积指数和左心室充盈压。依据患者左心室充盈压将173例患者分为舒功不全组（40例）和舒功正常组（133例）;对两组超声心动图参数进行比较,并分析左心房参数及左心室充盈压。结果舒功不全组左心房较大,与舒功正常组比较差异有统计学意义（P〈0.05）;且左心房参数也与左心室充盈压均呈正相关;ROC曲线分析,以左心房面积指数≥11.4cm2/m2为截点,诊断左心室舒张功能不全的特异性为67%,敏感性为63%,准确性为69%。结论左心室收缩功能正常的高血压患者左心房增大与其左心室充盈压的升高相关;而以左心房面积指数评价左心室充盈压的升高情况,远远优于左心房内径指数。因此,临床检查缺乏组织多普勒时,可以左心房面积指数作为左心室舒张功能不全诊断的辅助依据。

Objective To investigate the value of determination of left atria size and in diagnosis of left ventricular filling pressure by contrast echocardiography detection.Methods From January 2012 to April 2013 the left atria diameter of173 hypertension cases with normal left ventricular systolic function was determined by conventional echocardiography,the left atria area were measured and calculated index and the left atria diameter area index and the left ventricular filling pressure was calculated.Based on the left ventricular filling pressure the 173 patients were divided into diastolic function insufficiency group（40 cases） and diastolic reactive normal group（133 cases）;and two echocardiography parameters were compared and analyzed.Results Diastolic larger left atria function was insufficient compared with the normal group（P0.05）;the left atrium and left ventricular filling pressure parameters were positively correlated,and left atria area index number correlation coefficient large.ROC curve analysis showed that with the left a trial area index ≥11.4cm2/m2 as the,cut-off point,the specificity of diagnosis of left ventricular diastolic dysfunction was 67%,a sensitivity of 63%and an accuracy of 69%.Conclusions The left ventricular enlargement of normal left ventricular systolic function patients with high blood pressure is correlated with the rise of left ventricular filling pressure.To assess the rise of left ventricular based on thedetermination of rise of left atrium filling pressure is superior to the left atrium index.n.When the tissue Doppler is not available for clinical exmaation the left atrium area index determined couild be used as the auxiliary basis diagnosis of left ventricular diastolic dysfunction.