实时三维超声心动图和超声斑点追踪成像技术在老年冠心病患者中的应用价值

Application value of RT3DE and STI in elderly patients with CHD

目的 探究实时三维超声心动图(RT3DE)和超声斑点追踪成像技术(STI)在老年冠心病诊断及PCI术后疗效评价的应用价值。方法 选择2019年5月至2021年11月于盘锦辽油宝石花医院心胸外科治疗的老年冠心病患者152例为冠心病组及健康体检者102例为对照组,观察RT3DE参考指标:左心房最大容积(LAVmax)、左心房最小容积(LAVmin)、左心房收缩前容积(LAVp),左心房主动射血分数(LAAEF)、左心房被动射血分数(LAPEF);STI参考指标:左心房整体收缩期平均峰值应变率(mSRs)、左心房舒张早期平均峰值应变率(mSRe)、左心房舒张晚期平均峰值应变率(mSRa)。结果 冠心病组mSRs(3.19±0.67 vs 3.82±0.73)、mSRa(-4.57±0.62 vs-3.91±0.53)、LAAEF[(33.79±4.96)%vs(36.10±5.12)%]明显低于对照组(P<0.01),冠心病组mSRe、LAVmax、LAVp、LAVmin、LAPEF明显高于对照组(P<0.01)。RT3DE和STI指标联合检测诊断冠心病的ROC曲线下面积(AUC)明显高于各项指标单独检测(P<0.05)。RT3DE和STI指标联合检测评估冠心病PCI疗效的AUC明显高于mSRs、mSRe、mSRa单独检测(P<0.05)。结论 RT3DE、STI联合检查对老年冠心病具有诊断价值,且各指标与冠状动脉分级有相关性,并对PCI治疗疗效具有评估价值。

Objective To explore the application values of RT3DE and STI in the diagnosis of CHD in the elderly and in the evaluation of postoperative efficacy of PCI.Methods A total of 152 elderly CHD patients treated in Department of Cardiothoracic Surgery of Panjin Liaoyou Gem Flower Hospital between May 2019 and November 2021 were enrolled as the research objects, and another 102 healthy individuals who taking physical examination during the same period served as control.RT3DE indexes, including LAVmax, LAVmin, LAVp, LAAEF,LAPEF and STI indexes, including left atrial strain rates during systole, early and late of diastole(mSRs, mSRe and mSRa) were observed.Results The CHD group had significantly lower mSRs(3.19±0.67 vs 3.82±0.73),mSRa(-4.57±0.62 vs-3.91±0.53) and LAAEF [(33.79±4.96)% vs(36.10±5.12)%],while obviously higher mSRe, LAVmax, LAVp, LAVmin and LAPEF when compared with the control group(P<0.01).The AUC value of RT3DE combined with STI indexes in the diagnosis of CHD was significantly greater than that of single index(P<0.05).The AUC value of RT3DE combined with STI indexes in evaluating PCI efficacy was significantly greater than that of mSRs, mSRe and mSRa alone(P<0.05).Conclusion The combined detection of RT3DE and STI has diagnostic value for elderly CHD.These indexes are correlated with coronary grade, and are of significant values in evaluation for PCI efficacy.