超声心动图在老年冠心病患者诊断中的应用及对冠状动脉狭窄程度的评估价值

Application of echocardiography in the diagnosis of elderly patients with coronary heart disease and the value of evaluating the degree of coronary artery stenosis

目的 探究超声心动图在老年冠心病中的诊断价值及其评估老年冠心病患者冠状动脉狭窄的临床价值。方法 回顾性收集2022年2月至2023年9月于我院就诊的137例疑似老年冠心病患者,以冠状动脉造影为金标准,可将其分为冠心病组(63例)、健康组(74例),比较2组超声心动图参数,比较冠状动脉不同狭窄程度患者超声心动图参数[左室射血分数(LVEF)、左室舒张末期容积(LVEDV)、左室短轴缩短率(LVFS)、左室收缩末期容积(LVESV)、左室心肌质量(LVM)],采用Pearson法分析LVEDV、LVESV、LVFS、LVM及LVEF与Gensini评分的相关性,并对超声心动图诊断结果及诊断效能进行分析。结果 冠心病组LVEDV、LVESV、LVM均明显高于对照组,LVEF、LVFS均低于健康组照组(P<0.05);不同冠状动脉狭窄程度患者LVEDV、LVESV、LVM值比较:重度组>中度组>轻度组(P<0.05);冠状动脉轻度狭窄组LVEF、LVFS值>冠状动脉中度狭窄组LVEF、LVFS值>冠状动脉重度狭窄组LVEF、LVFS值(P<0.05);LVEF、LVFS与Gensini呈负相关,LVEDV、LVESV、LVM与Gensini评分呈正相关(P<0.05);超声心动图检查结果显示,61例阳性,76例阴性,其诊断灵敏度为93.6%,准确度95.6%,漏诊率为2.7%。结论 超声心动图在老年冠心病诊断中具有较高的诊断灵敏度,且漏诊率较低,可为临床评估患者冠状动脉狭窄程度提供可靠依据。

Objective To explore the diagnostic value of echocardiography in elderly patients with coronary artery stenosis and its clinical value.Methods A total of 137 suspected elderly patients with coronary heart disease(CHD)admitted to our hospital from February 2022 to September 2023 were retrospectively collected.Using coronary angiography as the gold standard,they could be divided into coronary heart disease group(63 cases)and healthy group(74 cases).Echocardiographic parameters of the two groups were compared.Echocardiographic parameters left ven-tricular ejection fraction(LVEF),left ventricular end-diastolic volume(LVEDV),left ventricular short-axis shortening rate(LVFS),left ventricular end-systolic volume(LVESV),left ventricular mass(LVM)were compared in patients with different degrees of coronary artery stenosis.Pearson method was used to analyze the correlation between LVEDV,LVESV,LVFS,LVM and LVEF and Gensini scores,and to analyze the diagnostic results and diagnostic efficacy of e-chocardiography.Results LVEDV,LVESV and LVM in CHD group were significantly higher than those in control group,LVEF and LVFS were lower than those in healthy group(P<0.05).LVEDV,LVESV and LVM values of patients with different degrees of coronary artery stenosis were compared:severe group>moderate group>mild group(P<0.05).LVEF and LVFS values in mild coronary artery stenosis group were higher than those in moderate coronary artery stenosis group and higher than those in severe coronary artery stenosis group(P<0.05).LVEF and LVFS were negatively correlated with Gensini,while LVEDV,LVESV and LVM were positively correlated with Gensini scores(P<0.05).The results of echocardiography showed that 61 cases were positive,76 cases were negative,the diagnostic sen-sitivity was 93.6%,the accuracy was 95.6%,and the missed diagnosis rate was 2.7%.Conclusion Echocardiography has high diagnostic sensitivity and low rate of missed diagnosis in elderly patients with coronary artery disease,which can provide a reliable basis for clinical evaluation of coronary artery stenosis.