摘要
目的采用超声斑点追踪(STI)分层应变技术检测心肌梗死(MI)患者心肌力学参数,并探究其对经皮冠状动脉介入治疗(PCI)术后短期预后的预测价值。方法选取2022年6月—2023年10月黄河三门峡医院收治的180例行PCI术的MI患者(MI组)及40例同期健康者(对照组)。根据短期预后将MI患者分为预后良好组(133例)和预后不良组(47例),采用ROC曲线分析心肌力学参数对PCI术后短期预后的预测价值。结果MI组左室射血分数,左室整体内、中、外层纵向应变(GLS-endo、GLS-mid、GLS-epi)及环向内、中、外层应变(GCS-endo、GCS-mid、GCS-epi)低于对照组,左心室收缩期容积及舒张末期容积高于对照组(P<0.05);预后不良组左室整体内、中、外层纵向应变及环向内、中、外层应变低于预后良好组(P<0.05)。Logistic回归分析显示,KillipⅢ级、6~12 h开通罪犯血管是短期预后不良的危险因素,GLS-endo、GCS-endo高水平是其保护因素(P<0.05)。ROC分析结果显示,GLS-endo、GCS-endo联合的预测效能高于单独检测(Z=2.019,P=0.044;Z=2.624,P=0.006)。结论GLS-endo、GCS-endo是MI患者PCI术后短期预后的影响因素,二者联合对短期预后不良的预测价值较高。
Objective Speckle tracking imaging(STI)stratified strain technique was used to detect the myocardial mechanics parameters of patients with myocardial infarction(MI),and its predictive value for the short-term prognosis after percutaneous coronary intervention(PCI)was explored.Methods From June 2022 to October 2023,180 MI patients(MI group)and 40 healthy patients(control group)undergoing PCI in Sanmenxia Hospital of the Yellow River were selected.MI patients were divided into two groups according to short-term prognosis,and receiver operating characteristic(ROC)curves were analyzed to evaluate the predictive value of myocardial mechanical parameters on short-term prognosis after PCI.Results The left ventricular ejection fraction,the global medial,middle,and outer longitudinal strains of the left ventricle(GLS-endo,GLS-mid,GLS-epi),and the annulus inward,middle,and outer layers(GCS-endo,GCS-mid,GCS-epi)in the MI group were lower than those in the control group,and the left ventricular systolic volume and end-diastolic volume were higher than those in the control group(P<0.05).The overall longitudinal strain of the left ventricle and the inward,middle,and outer strain of the left ventricle in the poor prognosis group were lower than those in the good prognosis group(P<0.05).Logistic regression results showed that Killip gradeⅢ,6-12 h vascular opening was a risk factor for poor short-term prognosis,and high levels of GLS-endo and GCS-endo were protective factors(P<0.05).ROC showed that the prediction efficiency of GLS-endo and GCS-endo combination was higher than that of the single detection(Z=2.019,P=0.044;Z=2.624,P=0.006).Conclusion GLS-endo and GCS-endo are the influencing factors of short-term prognosis after PCI in MI patients,and their combination has a high predictive value for poor short-term prognosis.
作者
李京良
张继红
陈芳
刘文军
LI Jingliang;ZHANG Jihong;CHEN Fang;LIU Wenjun(Department of Ultrasound,Huanghe Sanmenxia Hospital,Sanmenxia,Henan,472000,China;不详)
出处
《中华全科医学》
2025年第12期2109-2113,共5页
Chinese Journal of General Practice
基金
河南省医学科技攻关计划(联合共建)项目(LHGJ20210126)。
关键词
心肌梗死
斑点追踪分层应变技术
经皮冠状动脉介入术
心肌力学参数
预后
Myocardial infarction
Spot tracking layered strain technique
Percutaneous coronary intervention
Myocardial mechanical parameters
Prognosis
