老年钙化性心脏瓣膜病患者Crouse积分、IMT与瓣膜钙化程度的关系

Correlations between Crouse score, IMT, and the degree of valve calcification in elderly calcific heart valve disease patients

目的探讨老年钙化性心脏瓣膜病患者颈动脉斑块积分(Crouse积分)、内膜中层厚度(intima media thickness,IMT)与瓣膜钙化程度的关系。方法回顾性分析2020年4月至2023年3月收治的106例老年钙化性心脏瓣膜病患者的临床资料(观察组)。另选择90例颈动脉粥样硬化的非心脏瓣膜病患者作为对照组1、选取95例非老年钙化性心脏瓣膜病患者作为对照组2。单因素方差分析检验三组Crouse积分、IMT、管腔狭窄程度及老年钙化性心脏瓣膜病不同心瓣膜钙化程度患者Crouse积分、IMT。Pearson分析Crouse积分、IMT与心瓣膜钙化程度的相关性;受试者工作特征(ROC)曲线分析Crouse积分、IMT对老年钙化性心脏瓣膜病患者瓣膜钙化的预测价值。结果观察组Crouse积分、IMT、管腔狭窄程度均明显高于对照组1和对照组2(P<0.05)。老年钙化性心脏瓣膜病不同心瓣膜钙化程度患者Crouse积分、IMT比较:1级<2级<3级(P<0.05)。相关性分析结果显示,Crouse积分、IMT与老年钙化性心脏瓣膜病瓣膜钙化程度均呈明显正相关关系(r=0.585、0.623,P<0.05)。绘制Crouse积分、IMT预测老年钙化性心脏瓣膜病患者瓣膜钙化的ROC曲线示,Crouse积分、IMT联合预测的AUC为0.802(95%CI为0.738~0.867),明显高于各指标单一预测的AUC,最佳诊断敏感度和特异度分别为0.887、0.794(P<0.05)。结论老年钙化性心脏瓣膜病患者Crouse积分、IMT存在异常增高,且与瓣膜钙化程度呈正相关,测量上述指标有助于对心脏瓣膜钙化程度进行评估。

Objective To explore the relationship between Crouse Score,intima-media thickness(IMT),and the degree of valve calcification in elderly patients with calcific heart valve disease.Methods A retrospective analysis was conducted on the clinical data of 106 elderly patients with calcific heart valve disease from April 2020 to March 2023(Observation group).Additionally,90 patients with carotid atherosclerosis without heart valve disease were selected as control group 1,and 95 non-elderly patients with calcific heart valve disease were selected as control group 2.Single-factor analysis of variance was used to compare Crouse Score,IMT,luminal stenosis,and Crouse Score and IMT in patients with different degrees of valve calcification in calcific heart valve disease.Pearson analysis was employed to explore the correlation between Crouse Score,IMT,and the degree of valve calcification.ROC curve analysis was performed to evaluate the predictive value of Crouse Score and IMT for valve calcification in elderly patients with calcific heart valve disease.Results Crouse Score,IMT,and luminal stenosis in the observation group were significantly higher than those in control group 1 and control group 2(P<0.05).For patients with different degrees of valve calcification in calcific heart valve disease,Crouse Score and IMT were compared as follows:Grade 1<Grade 2<Grade 3(P<0.05).The correlation analysis results showed that Crouse Score and IMT were positively correlated with the degree of valve calcification in elderly patients with calcific heart valve disease(r=0.585,0.623,P<0.05).The ROC curve demonstrated that the AUC of the joint prediction of Crouse Score and IMT for valve calcification in elderly patients with calcific heart valve disease was 0.802(95%CI:0.738-0.867),significantly higher than the AUC for individual predictions,with optimal diagnostic sensitivity and specificity of 0.887 and 0.794,respectively(P<0.05).Conclusion Crouse Score and IMT are abnormally elevated in elderly patients with calcific heart valve disease and are positively correlated with the degree of valve calcification.Measurement of these indicators assists in the assessment of heart valve calcification levels.