摘要
目的:探讨心脏彩色多普勒超声联合心电图对肺源性心脏病(PHD)患者右心功能不全的预测价值。方法:回顾性分析2020年1月~2023年12月安徽医科大学第一附属医院东城院区收治的100例PHD患者,将6min步行试验(6MWT)结果≥350m的64例患者纳入右心功能良好组,其余36例患者纳入右心功能不全组,对比两组心脏彩超指标[等容舒张时间(IVRT)、等容收缩时间(IVCT)与右心室Tei指数]、心电图指标[24 h平均R-R间期标准差(SDNN)、每5 min正常R-R间期标准差(SDANN)、低频成分和高频成分的比值(LF/HF)]差异,绘制受试者工作特征(ROC)曲线分析心脏彩超、心电图及其联合检测对PHD患者右心功能不全的诊断价值,采用Spearman相关系数分析心脏彩超、心电图及其联合检测与PHD患者右心功能不全的相关性。结果:与右心功能良好组相比,右心功能不全组IVRT[(120.64±14.08)ms比(97.87±10.93)ms]、IVCT[(84.28±12.33)ms比(71.92±10.61)ms]及Tei指数[(0.85±0.11)比(0.63±0.07)]均显著增加(P均<0.001),SDNN[(75.52±12.58)ms比(85.58±11.75)ms]、SDANN[(63.86±10.92)ms比(76.75±11.71)ms]及LF/HF[(1.33±0.19)比(1.84±0.27)]均显著减少(P均<0.001)。ROC分析显示,心脏彩超与心电图联合诊断PHD患者右心功能不全的曲线下面积(AUC)为0.911(95%CI:0.838~0.959),高于心脏彩超单独诊断的0.775(95%CI:0.681~0.853)与心电图0.688(95%CI:0.588~0.777)(Z=2.404、3.968,P=0.016、0.001)。Spearman相关分析显示,心脏彩超(r=0.547)、心电图(r=0.375)其联合检测(r=0.810)与PHD患者右心功能不全均呈显著正相关(P均<0.001),并且联合检测与PHD患者右心功能不全的相关性显著更高。结论:彩色多普勒超声联合心电图用于PHD患者右心功能不全具有较高的诊断效能。
Objective:To investigate the predictive value of color Doppler ultrasound combined with electrocardiogram for right heart dys function in patients with pulmonary heart disease(PHD).Methods:A total of 100 PHD patients admitted in Dongcheng Branch of First Affiliated Hospital of Anhui Medical University between January 2020 and December 2023 were retrospectively analyzed.According to results of 6min walking test(6MWT),patients were divided into good right heart function group(n=64,≥350m)and right heart dysfunction group(n=36,<350m).The indexes of cardiac color ultrasound[isovolumic relaxation time(IVRT),isovolumetric contraction time(IVCT)and right ventricular Tei index],ECG[24h mean R-R interval standard deviation(SDNN),normal R-R interval standard deviation per 5min(SDANN)and the ratio of low frequency components to high frequency components(LF/HF)]were compared between two groups.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of color Doppler ultrasound,ECG and their combination for right heart dysfunction in PHD patients.Spearman correlation coefficient was used to analyze the association of color Doppler ultrasound,ECG and their combination with right heart dysfunction in PHD patients.Results:Compared with those in good right heart function group,patients in right heart dysfunction group had significant higher IVRT[(120.64±14.08)ms vs.(97.87±10.93)ms],IVCT[(84.28±12.33)ms vs.(71.92±10.61)ms]and Tei index[(0.85±0.11)vs.(0.63±0.07)](P<0.001 all),and significant lower SDNN[(75.52±12.58)ms vs.(85.58±11.75)ms],SDANN[(63.86±10.92)ms vs.(76.75±11.71)ms]and LF/HF[(1.33±0.19)vs.(1.84±0.27)](P<0.001 all).ROC curve indicated that the AUC of color Doppler ultrasound combined ECG in diagnosing right heart dysfunction in PHD patients was 0.911(95%CI 0.838~0.959),which was significantly higher than those of color Doppler ultrasound[0.775(95%CI 0.681~0.853),Z=2.404,P=0.016]and ECG[0.688(95%CI 0.588~0.777),Z=3.968,P=0.001]alone.Spearman correlation analysis indicated that there was a significant positive correlation of color Doppler ultrasound(r=0.547),ECG(r=0.375)and their combination(r=0.810)with right heart dysfunction in PHD patients(P<0.001 all),and the correlation between combined detection and right heart dysfunction in PHD patients was significantly higher.Conclusion:Color Doppler ultrasound combined with ECG possesses high diagnostic performance for right heart dysfunction in PHD patients.
作者
吴婉婉
沈海波
马春莲
黄典栋
汪芳红
王慧琴
阚丽
孙健
沈霁雯
黄猛
WU Wan-wan;SHEN Hai-bo;MA Chun-lian;HUANG Dian-dong;WANG Fang-hong;WANG Hui-qin;KAN Li;SUN Jian;SHEN Ji-wen;HUANG Meng(Department of Ultrasound Medicine,Dongcheng Branch,First Affiliated Hospital of Anhui Medical University,Hefei,Anhui,231600,China)
出处
《心血管康复医学杂志》
2025年第3期332-337,共6页
Chinese Journal of Cardiovascular Rehabilitation Medicine
关键词
肺心病
超声心动描记术
多普勒
心电描记术
Pulmonary heart disease
Echocardiography,Doppler
Electrocardiography
