三维斑点追踪成像及DDIAS诊断中度和重度冠状动脉狭窄的研究

Study of Three-dimensional Speckle Tracking Imaging and DDIAS in the Diagnosis of Moderate and Severe Coronary Artery Stenosis

本研究考察三维斑点追踪成像(3D-STI)技术及DNA损伤诱导凋亡抑制因子(DDIAS)诊断中度和重度冠状动脉狭窄的价值。对112例冠心病患者进行3D-STI检查,并于24 h内经冠状动脉造影(CAG)证实为冠状动脉狭窄。根据CAG结果,按狭窄百分比将患者分为轻微、轻度、中度和重度组。同时选择30例健康体检者作为对照组。通过酶联免疫吸附测定(ELISA)法检测冠心病患者和健康体检者的血清DDIAS。结果显示,随着狭窄程度的升高,3D-GAS、3D-GLS、3D-GCS和3D-GRS均逐渐升高(P<0.05)。冠心病患者的血清DDIAS水平高于健康体检者,且随着狭窄程度的升高,血清DDIAS水平逐渐升高(P<0.05)。3D-GAS诊断中度和重度冠状动脉狭窄的ROC曲线下面积(AUC)(0.846)和敏感性(98.28%)较高,但特异性(57.41%)较低。血清DDIAS诊断中度和重度冠状动脉狭窄的AUC、敏感性和特异性依次为0.910、84.48%和90.74%。3D-STI参数联合血清DDIAS诊断中度和重度冠状动脉狭窄的AUC、敏感性和特异性依次为0.979、96.55%和96.30%。3D-STI参数联合血清DDIAS诊断中度和重度冠状动脉狭窄的AUC和特异性高于单独诊断,敏感性仅次于3D-GAS单独诊断,有助于对冠状动脉狭窄的准确诊断。

This study investigated the value of three-dimensional speckle tracking imaging(3D-STI)and DNA damage-induced apoptosis suppressor(DDIAS)in the diagnosis of moderate and severe coronary artery stenosis.112 patients with suspected coronary heart disease were examined by 3D-STI,and coronary artery stenosis was confirmed by coronary angiography(CAG)within 24 hours.Based on CAG results,the patients were divided into slight,mild,moderate,and severe groups by percentage of stenosis.At the same time,30 healthy subjects were selected as the control group.Serum DDIAS in patients with coronary heart disease and healthy subjects were detected by enzyme-linked immunosorbent assay(ELISA).The results showed that with the increase of stenosis degree,3D-GAS,3D-GLS,3D-GCS and 3D-GRS all increased gradually(P<0.05).The level of serum DDIAS in patients with coronary heart disease was higher than that in healthy subjects,and the level of serum DDIAS gradually increased with the increase of stenosis degree(P<0.05).The area under the ROC curve(AUC)(0.846)and sensitivity(98.28%)of 3D-GAS for diagnosing moderate and severe coronary artery stenosis were higher,but the specificity was lower(57.41%).The AUC,sensitivity and specificity of serum DDIAS in the diagnosis of moderate and severe coronary artery stenosis were 0.910,84.48%and 90.74%,respectively.The AUC,sensitivity and specificity of 3D-STI parameters combined with serum DDIAS in the diagnosis of moderate and severe coronary artery stenosis were 0.979,96.55%and 96.30%,respectively.The AUC and specificity of 3D-STI parameters combined with serum DDIAS in the diagnosis of moderate and severe coronary artery stenosis were higher than those of single diagnosis,and the sensitivity was second only to that of 3D-GAS alone.It is helpful for the accurate diagnosis of coronary artery stenosis.