超声监测下腔静脉变异度对Valsalva法终止室上性心动过速的预测价值

The predictive value of ultrasound monitoring of inferior vena cava variability in the termination of supraventricular tachycardia by Valsalva method

目的:探讨使用超声监测下腔静脉变异度对Valsalva动作终止室上性心动过速的预测价值。方法:选取2016-12—2017-12期间于我院急诊科使用Valsalva动作终止室上性心动过速的患者96例,按是否恢复窦性心律分为成功组55例、失败组41例。比较两组患者进行Valsalva动作过程中下腔静脉变异度(Divc)。绘制ROC受试者工作曲线,评价对使用Valsalva动作终止室上性心动过速患者的预测价值。结果:成功组Divc为(0.56±0.12)mm,失败组为(0.28±0.09)mm,两组比较差异有统计学意义(P<0.05)。Divc预测使用Valsalva动作成功终止室上性心动过速的ROC曲线下面积为0.863(95%可信区间:0.752～0.925),以Divc≤0.39为截断值预测使用Valsalva动作不能终止室上性心动过速的敏感性为>82.3%,特异性为95.2%。结论:使用超声监测Divc对预测Valsalva动作是否能够终止室上性心动过速有一定的指导价值,其特异性较高。

Objective:To explore the predictive value of ultrasonic monitoring of inferior vena cava variability in the termination of supraventricular tachycardia by Valsalva maneuver.Method:Ninety-six cases of supraventricular tachycardia were selected from the emergency department of our hospital from December 2016 to December 2017,and 55 cases were assigned into successful group and 41 cases assigned into failure group.The changes of inferior vena cava in two groups of patients during Valsalva operation were compared.The ROC receiver operating curve was drawn to evaluate the predictive value of Valsalva method in the termination of supraventricular tachycardia.Result:The Divcin the successful group was(0.56±0.12)mm,and the failure group was(0.28±0.09)mm.The difference between the two groups was statistically significant(P<0.05).Divcpredicted the use of Valsalva maneuver to successfully terminate the area of supraventricular tachycardia with an area of 0.863(95%confidence interval;0.752~0.925),and the sensitivity of Valsalva maneuver to not terminate the supraventricular tachycardia was more than 82.3%and the specificity was 95.2% with the Divc<0.39 as the truncated value.Conclusion:Ultrasound monitoring of Divchas certain guiding value for predicting whether Valsalva maneuver can terminate supraventricular tachycardia,and its specificity is high.