心血管超声在心血管疾病中的诊断效能

Diagnostic efficacy of cardiovascular ultrasonography in cardiovascular disease

目的探讨心血管超声检查在心血管疾病中的诊断效能。方法选取2020年6月至2021年12月浙江省台州医院收治的180例疑似心血管疾病患者,以心血管造影结果为“金标准”,分析心血管超声检查的诊断价值,比较不同主干狭窄程度患者的主动脉内径、左心房左右径及右心房左右径,比较三尖瓣反流不同严重程度患者的反流速度、肺动脉收缩压(pulmonary arterial systolic pressure,PASP),采用受试者工作曲线(receiver operating characteristic,ROC)曲线分析反流速度和PASP对重度三尖瓣反流患者的诊断价值。结果心血管超声诊断心血管疾病的敏感度为96.5%,特异性为80.0%,Kappa=0.644(P<0.05);诊断肺动脉栓塞、伴下肢静脉血栓、冠心病的敏感度分别为95.7%、92.9%、94.1%,特异性分别为97.4%、95.3%、94.9%,Kappa=0.991(P<0.05);主干狭窄≤50%患者主动脉内径、右心房左右径、左心房左右径均低于主干狭窄>50%患者(P<0.05);三尖瓣反流程度越严重,反流速度和PASP值越大,重度三尖瓣反流患者反流速度和PASP值显著高于轻中度患者(P<0.05);反流速度、PASP的AUC为0.891、0.894。结论心血管超声检查可用于患者术前诊断,明确患者病情严重程度,其影像学特征可作为评估患者预后的重要指标。

Objective To explore the diagnostic efficacy and prognosis of cardiovascular ultrasound in cardiovascular diseases.Methods A total of 180 patients with suspected cardiovascular disease from June 2020 to December 2021 in Taizhou Hospital of Zhejiang Province were selected.The diagnostic value of cardiovascular ultrasonography was analyzed with the results of cardiovascular angiography as the gold standard.The aortic diameter,left and right atrial diameter and right and left atrial diameter of patients with different main stenosis were compared.The regurgitation velocity and pulmonary artery systolic pressure in patients with different severity of tricuspid regurgitation were compared.The diagnostic value of regurgitation velocity and PASP in patients with severe tricuspid regurgitation was analyzed by receiver operating characteristic(ROC)curve.Results The sensitivity of cardiovascular ultrasound in the diagnosis of cardiovascular disease was 96.5%,the specificity was 80.0%,Kappa=0.644(P<0.05).The sensitivity of diagnosis of pulmonary embolism,lower extremity venous thrombosis and coronary heart disease was 95.7%,92.9%and 94.1%,respectively,and the specificity was 97.4%,95.3%and 94.9%,respectively,Kappa=0.991(P<0.05).The aortic diameter,right atrial diameter and left atrial diameter in patients with main stenosis≤50%were lower than those in patients with main stenosis>50%(P<0.05).The more severe the tricuspid regurgitation,the greater the regurgitation velocity and PASP value.The regurgitation velocity and PASP value of patients with severe tricuspid regurgitation were significantly higher than those of patients with mild to moderate tricuspid regurgitation(P<0.05).The AUC of reflux velocity and PASP were 0.891 and 0.894.Conclusion Cardiovascular ultrasonography can be used for preoperative diagnosis of patients and effectively determine the severity of patients'condition,Its imaging features can be used as an important indicator to evaluate the prognosis of patients.