目的:比较左室节段性室壁运动超声心动图定量分析方法在冠心病诊断中的准确性。方法165例研究对象,分成3组:正常对照组60例,心肌梗死组45例,冠状动脉狭窄组60例。采用彩色多普勒超声仪检查,观察指标包括:左室前间隔的内膜运动幅度(EndoD )、室壁增厚率(ΔT H )、收缩期径向应变(RS )、收缩期组织速度(VS)。应用ROC曲线分析比较各指标诊断冠心病的准确性。结果(1)冠状动脉狭窄组及心肌梗死组的RS、ΔTH、EndoD、VS明显低于正常对照组(P<0.01)。(2)RS、ΔTH、EndoD、VS检测心肌梗死及冠状动脉狭窄的准确率分别为:89.3%、89.3%、81.3%、80.7%及68.1%、70.0%、61.9%、60.0%。(3)RS、ΔTH、EndoD、VS诊断心肌梗死及冠状动脉狭窄的受试者工作特征(ROC )曲线下面积分别为:0.868、0.863、0.833、0.859及0.724、0.705、0.689、0.663。结论室壁增厚率及径向应变诊断冠心病的准确性最高。
Objective To compare the accuracy of echocardiographic quantitative analysis methods of regional left ventricular wall motion (RLVWM ) in diagonosis of CHD . Methods 165 cases were divid-ed to 3 groups ,Control-group :60 cases ,MI-group :45 cases ,CAD-group:60 cases RLVWM analysis :Two-dimensional echocardiography(2DE) was performed in all subjects by GE Vivid7 dimension . The radial strain (RS) ,Wall thickening (ΔTH) ,endocardial displacement (EndoD) ,systolic tissue velocity (VS) were assessed in anteseptum . Sensitivity and specificity of each parameter to detect RLVWMA were obtained using receiver operating characteristic analysis (ROC) . All parameters were compared be-tween MI-group ,CAD-group and control-group ,and their accuracy in the detection of RLVWMA and in the diagnosis of coronary heart disease (CHD) were evaluated . Results (1) The measurements of RS ,ΔTH ,EndoD ,VS in MI-and CAD-group were remarkable lower than those in control group(P〈0 .01) , respectively . (2) The accuracy of RS ,ΔTH ,EndoD ,VS in detection of RLVWMA in MI-group were 89 .3% ,89 .3% ,81 .3% ,80 .7% ,respectively ;and in CAD-group were 68 .1% ,70 .0% ,61 .9% , 60 .0% ,respectively .(3) The ROC area of RS ,ΔTH ,EndoD ,VS in detection of RLVWMA in MI-group were 0 .868 ,0 .863 ,0 .833 ,0 .859 ,respectively ;and in CAD-group were 0 .724 ,0 .705 ,0 .689 ,0 .663 , respectively . Conclusions ΔTH and RS were the most accurate in the detection of RLVWMA .