心脏超声在冠心病节段性室壁运动异常诊断中的应用效果

Effectiveness of Cardiac Ultrasound in the Diagnosis of Segmental Ventricular Wall Motion Abnormalities in Coronary Artery Disease

目的:分析心脏超声在诊断冠心病节段性室壁运动异常中的应用效果。方法:选取2021年1月-2022年8月曲靖市第一人民医院收治的疑似冠心病节段性室壁运动异常患者146例为观察对象,均行心脏超声检查,心脏超声检查结束后行左心室造影检查,以左心室造影检查结果为金标准。结果:两组检查方式冠心病节段性室壁运动异常的检出率比较,差异无统计学意义(P>0.05);心脏超声对冠心病节段性室壁运动异常患者的诊断敏感度92.96%、特异度50.00%、准确度91.78%、误诊率50.00%、漏诊率7.04%;冠心病节段性室壁运动异常患者基底段左心室舒张末期容量(LVEDV)、收缩末期容量(LVESV)值高于中间段,差异有统计学意义(P<0.05);基底段和中间段每搏输出量(SV)值比较,差异无统计学意义(P>0.05);基底段射血分数(LVEF)值低于中间段,差异有统计学意义(P<0.05);中间段LVEDV、LVESV、SV、LVEF值高于心尖段,差异有统计学意义(P<0.05);心脏超声检查不良反应发生率低于左心室造影检查,差异有统计学意义(P<0.05)。结论:心脏超声对冠心病节段性室壁运动异常诊断准确率较高,能对运动异常类型进行鉴别诊断,准备评估患者的左心室功能,不良反应少,安全性较高。

Objective:To analyze the effect of cardiac ultrasound in the diagnosis of segmental ventricular wall motion abnormalities in coronary artery disease.Methods:146 patients with suspected segmental ventricular wall motion abnormalities in coronary artery disease admitted to the Qujing First People's Hospital from January 2021 to August 2022 were selected as observation subjects.All of them underwent cardiac ultrasound examination,and left ventriculography was performed after cardiac ultrasound examination,and the results of left ventriculography examination were used as the gold standard.Results:There was no statistically significant difference in the detection rate of segmental ventricular wall motion abnormalities in coronary artery disease between the two examination modalities(P>0.05).The diagnostic sensitivity of cardiac ultrasound for patients with segmental ventricular wall motion abnormalities in coronary artery disease was 92.96%,specificity 50.00%,accuracy 91.78%,misdiagnosis rate 50.00%,and leakage rate 7.04%.The left ventricular end-diastolic volume(LVEDV)and end-systolic volume(LVESV)values in patients with segmental ventricular wall motion abnormalities in coronary artery disease were higher in the basal segment than in the intermediate segment,with statistically significant differences(P<0.05).There was no statistically significant difference between the basal and intermediate segments in terms of output per beat(SV)values(P>0.05).The basal segment ejection fraction(LVEF)values were lower than those of the intermediate segment,and the difference was statistically significant(P<0.05).LVEDV,LVESV,SV,and LVEF values in the intermediate segment were higher than those in the apical segment,and the difference was statistically significant(P<0.05).The incidence of adverse reactions of cardiac ultrasound was lower than that of LV angiography,and the difference was statistically significant(P<0.05).Conclusion:Cardiac ultrasound has a high diagnostic accuracy for segmental ventricular wall motion abnormalities in coronary artery disease,can make differential diagnosis of the type of motion abnormalities,and is prepared to assess the left ventricular function of patients with fewer adverse effects and higher safety.