急性心肌梗死急诊介入治疗前后心脏彩超参数对预后的评估作用

Effect of cardiac color doppler ultrasound parameters on prognosis of acute myocardial infarction before and after emergency interventional treatment

目的 探讨急性心肌梗死(AMI)急诊介入治疗前后心脏彩超参数对预后的评估作用。方法 回顾性分析2019年11月-2020年1月于玉山县中医院行经皮冠状动脉介入(PCI)治疗的112例AMI患者的临床资料,根据预后结局分为预后不良组(n=26)和预后良好组(n=86),所有入选者均行心脏彩超检查。比较2组PCI治疗前后心脏彩超参数[左室射血分数(LVEF)、左室舒张末期容积指数(LVEDVI)、左室收缩末期容积指数(LVESVI)、心脏指数(CI)]变化,并分析心脏彩超参数在AMI患者PCI预后中的预测价值。结果 2组治疗前LVEF、LVEDVI、LVESVI、CI等各项参数比较,差异无统计学意义(P>0.05);预后良好组治疗后LVEF、CI高于预后不良组,LVEDVI、LVESV低于预后不良组,差异有统计学意义(P<0.05)。ROC曲线结果显示,LVEF、LVEDVI、LVESVI、CI预测AMI患者PCI预后的曲线下面积(AUC)为0.941,0.793,0.702,0.712,预测价值均较高。结论 动态监测心脏彩超参数能够评估PCI治疗效果,对AMI患者预后进行准确评估,具有较高的临床应用价值。

Objective To investigate the effect of cardiac color doppler ultrasound parameters on prognosis of acute myocardial infarction(AMI)before and after emergency interventional treatment.Methods The clinical data of 112 AMI patients who underwent Percutaneous coronary intervention(PCI)in our hospital from November 2019 to January 2020 were retrospectively analyzed.All patients were divided into poor prognosis group(n=26)and good prognosis group(n=86)according to the outcome.All selected candidates underwent cardiac color doppler ultrasound examination.The changes of cardiac color doppler ultrasound parameters[Left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume index(LVEDVI),left ventricular end-systolic volume index(LVESVI),cardiac index(CI)]before and after PCI were compared between the two groups,and the predictive value of cardiac color doppler ultrasound parameters in the prognosis of PCI in AMI patients was analyzed.Results There was no significant difference in LVEF、LVEDVI、LVESVI、CI parameters between the two groups before treatment(P>0.05).LVEF and in the good prognosis group were higher than the poor prognosis group,and LVEDVI and LVESVI were lower than the poor prognosis group,the difference was statistically significant(P<0.05),.ROC curve results showed that the area under curve(AUC)of LVEF,LVEDVI,LVESVI and CI for predicting the prognosis of PCI in AMI patients were 0.941,0.793,0.702 and 0.712,with high predictive value.Conclusion Dynamic monitoring of cardiac color ultrasound parameters can evaluate the therapeutic effect of PCI and accurately evaluate the prognosis of patients with AMI,which has high value in clinical application.