摘要
目的:评估心脏彩超多参数(左心室射血分数(left ventricular ejection fraction,LVEF)、左心室整体长轴应变(global longitudinal strain,GLS)、心肌收缩早期延迟时间、左心室心肌做功指数(Tei指数))联合检测在老年门诊体检无症状性心肌缺血中的诊断价值。方法:回顾性选取2022年1月至2024年2月在空军军医大学第一附属医院老年门诊体检的95例无症状性心肌缺血患者为研究组,另选取同期95例老年体检健康者为对照组。所有入选对象均进行Philips CX50心脏彩超检查,收集入选对象一般资料及心脏彩超相关参数。Logistic回归分析心脏彩超参数与无症状性心肌缺血的关系。受试者操作特征(ROC)曲线分析各参数单独及联合检测对无症状性心肌缺血的诊断价值。结果:Logistic回归显示,LVEF(OR=0.787,95%CI=0.690~0.898,P<0.001)、左心室GLS(OR=0.362,95%CI=0.223~0.587,P<0.001)、心肌收缩早期延迟时间(OR=1.189,95%CI=1.056~1.338,P=0.004)、左心室Tei指数(OR=13.317,95%CI=1.007~176.105,P=0.013)均为诊断无症状性心肌缺血的独立预测因子。心脏彩超参数LVEF(曲线下面积(AUC)=0.878)、左心室GLS(AUC=0.892)、心肌收缩早期延迟时间(AUC=0.836)、左心室Tei指数(AUC=0.778)均对无症状性心肌缺血具有良好诊断效能,各参数联合检测时AUC可达0.986,灵敏度为96.84%,特异度为92.63%。结论:心脏彩超多参数联合检测可显著提高无症状性心肌缺血的诊断效能,有助于老年门诊体检中无症状性心肌缺血的客观评估与早期筛查。
Objective:To evaluate the diagnostic value of multi-parameter echocardiography[including left ventricular ejection fraction(LVEF),global longitudinal strain(GLS),early systolic lengthening time,left ventricular myocardial performance index(Tei index)]in asymptomatic myocardial ischemia during geriatric outpatient health examinations.Methods:95 patients with asymptomatic myocardial ischemia undergoing geriatric outpatient health examinations at the First Affiliated Hospital of Air ForceMedical University from January 2022 to February 2024 were retrospectively selected as the study group.Another 95 healthy elderlyindividuals undergoing health examinations during the same period were selected as the control group.All subjects underwent PhilipsCX50 echocardiography.General information and echocardiographic parameters were collected.Logistic regression analysis was usedto assess the relationship between echocardiographic parameters and asymptomatic myocardial ischemia.Receiver operatingcharacteristic (ROC) curve analysis was performed to evaluate the diagnostic value of individual and combined parameters forasymptomatic myocardial ischemia.Results:Logistic regression showed that LVEF (OR=0.787,95%CI=0.690 - 0.898,P<0.001),left ventricular GLS(OR=0.362,95%CI=0.223-0.587,P<0.001),early systolic lengthening time(OR=1.189,95%CI=1.056 - 1.338,P=0.004),and left ventricular Tei index(OR=13.317,95%CI=1.007 - 176.105,P=0.013) were independentpredictors for diagnosing asymptomatic myocardial ischemia.Echocardiographic parameters LVEF(area under the curve(AUC)=0.878),left ventricular GLS(AUC=0.892),early systolic lengthening time(AUC=0.836),and left ventricular Tei index(AUC=0.778) all showed good diagnostic efficacy for asymptomatic myocardial ischemia.The combined detection of these parametersachieved an AUC of 0.986,with a sensitivity of 96.84% and specificity of 92.63%.Conclusion:Multi-parameter echocardiographycan significantly improve the diagnostic efficacy for asymptomatic myocardial ischemia,aiding in objective assessment and earlyscreening during geriatric outpatient health examinations.
作者
杜文静
王昱锦
DU Wenjing;WANG Yujin(Outpatient Department,The First Affiliated Hospital of PLA Air Force Medical University,Shaanxi 710032,China)
出处
《影像科学与光化学》
2025年第1期29-34,47,共7页
Imaging Science and Photochemistry
基金
陕西省重点研发计划项目(2017SF-169)。
关键词
无症状性心肌缺血
心脏彩超
老年
门诊
健康体检
诊断价值
asymptomatic myocardial ischemia
echocardiography
elderly
outpatient service
health examination
diagnostic value
