肥厚型心肌病患者冠状动脉微循环功能评价中心脏超声造影与磁共振成像的应用

Application of contrast-enhanced echocardiography and MRI in evaluating coronary microcirculation function in HCM patients

目的 分析肥厚型心肌病(HCM)患者诊断中,心脏超声造影(MCE)对患者冠状动脉微循环功能的评价意义。方法 取我院收治的124例疑似HCM患者为对象,所有患者均接受磁共振成像(MRI)检查与MCE检查,比较2种检查方式的诊断效能,同时分析MCE检查对患者冠状动脉微循环功能的评估检查。结果 MCE诊断的灵敏度、特异度、阳性/阴性预测值、符合率(96.7%、93.8%、93.6%、96.8%、95.2%)高于MRI(83.3%、81.3%、80.7%、83.9%、82.3%)(χ^(2)=5.93、4.57、4.59、5.91、10.31;P=0.015、0.033、0.032、0.015、0.001)。单因素结果分析显示,冠状动脉微循环障碍组患者的高密度脂蛋白(HDL)降低、超敏肌钙蛋白Ⅰ(hs-cTnⅠ)升高(P<0.05);Logistic回归分析显示,hs-c TnI升高是导致患者冠状动脉微循环障碍发生的独立危险因素(P<0.05)。结论 HCM患者诊断中MCE能有效提升诊断准确率,且能有效区分HCM患者的冠状动脉微循环功能障碍情况,hs-cTnI升高可作为冠状动脉微循环障碍的重要参考指标。

Objective To analyze the diagnostic significance of contrast-enhanced echocardiography(MCE)in patients with hypertrophic cardiomyopathy(HCM)in evaluating coronary microcirculation function.Methods A total of 124 suspected HCM patients admitted to our hospital were selected as the subjects,and all patients underwent MRI and MCE examinations.The diagnostic efficacy of the two examination methods was compared,and the evaluation of the MCE examination on the coronary microcirculation function of patients was analyzed.Results The sensitivity,specificity,positive/negative predictive value,and coincidence rate(96.7%,93.8%,93.6%,96.8%,95.2%)of MCE diagnosis were higher than those of MRI(83.3%,81.3%,80.7%,83.9%,82.3%)(χ^(2)=5.93,4.57,4.59,5.91,10.31;P=0.015,0.033,0.032,0.015,0.001).Univariate result analysis showed that patients with coronary microcirculation dis-orders had a decrease in HDL and an increase in hypersensitive cardiac troponin(hs-cTnl)(P<0.05).Logistic regres-sion analysis showed that elevated hs-cTnl was an independent risk factor for the occurrence of coronary artery micro-circulation disorders in patients(P<0.05).Conclusion MCE in the diagnosis of HCM patients can effectively improve diagnostic accuracy and distinguish the status of coronary microcirculation dysfunction in HCM patients.Elevated hs-cTnl can serve as an important reference indicator for coronary microcirculation dysfunction.