| 摘要: |
| 目的 探讨二维斑点追踪超声（2D-STE）分析缺血性扩张型心肌病（IDCM）和非缺血性扩张型心肌病（NIDCM）的心脏超声特征。方法 按照冠状动脉造影结果选41例IDCM和 42例NIDCM 患者作为研究组 ，另设24例健康者为对照组。应用2D-STE比较左心室整体纵向应变值（GLS）、环向应变值（GCS）、径向应变值（GSR）。 结果 与IDCM组相比，NIDCM组LVEF明显减低（P<0.05）；NIDCM组LVEDD稍增大，但差异无统计学意义。NIDCM组和IDCM组GLS差异无显著性意义（-9.9±3.4% vs. -9.6±3.3%；P>0.05），但两组GLS均显著低于对照组。NIDCM组GCS和GRS均显着低于IDCM组（-5.4±2.6% vs. -7.0±2.5%；7.5±4.5% vs. 10.7±4.7%，均P<0.05）。ROC曲线分析结果示GLS区别NIDCM与IDCM的AUC值不佳（AUC值0.525，诊断截点-10.1% ，敏感性51%，特异性63%），但GRS具有最大AUC值（AUC值0.701），最佳诊断截点为8.53%，敏感性为66%，特异性为74%。 结论 IDCM患者和NIDCM患者左室心肌各节段应变值明显减低，GRS 检测可用于临床对IDCM和NIDCM患者的初步分层。 |
| 关键词: 扩张型心肌病 缺血性心肌病 心脏超声 二维斑点追踪 应变 |
| DOI： |
| 投稿时间：2020-05-19修订日期：2020-06-03 |
| 基金项目:CD151调控VE-cadherin的囊泡运输维持血管稳定性的机制研究 |
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| The value of two-dimensional speckle tracking echocardiography in differential diagnosis of ischemic cardiomyopathy and nonischemic dilated cardiomyopathey. |
| ZUO Houjuan,ZHANG Yan,MA Fei,LI Rui,DUAN Quanlu,WANG Hong |
| (Division of Cardiology,Department of Internal Medicine,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology) |
| Abstract: |
| Objective To analyze the cardiac function of ischemic dilated cardiomyopathy (IDCM) and non-ischemic dilated cardiomyopathy (NIDCM) patients by the two dimensional speckle tracking echocardiography (2D STE) . Methods According to the results of coronary angiography, 41 IDCM patients and 42 NIDCM patients were taken as the research groups 24 normal patients were taken as the control group. Retrospective analysis of the cardiac ultrasound characteristics of those patients was taken. The 2D STE was used to measure the left ventricular global longitudinal strain (GLS), global circumferential strain (GCS) and global radial strain (GRS)of each group, and strain parameters between the groups were compared.Results Compared with the IDCM group, LVEF was significantly lower in the NIDCM group (P<0.05); GLS in both groups was much lower than that in the control group，but GLS between the NIDCM group and the IDCM group demonstrated no significant difference (-9.9±3.4% vs. -9.6±3.3%; P >0.05), the GCS and GRS in the NIDCM group were significantly lower than those in the IDCM group (-5.4±2.6% vs. -7.0±2.5%; 7.5±4.5% vs. 10.7±4.7%, both P <0.05). The results of ROC curve demonstrated that the GRS has the largest AUC value (AUC: 0.701), with the cutoff 8.53%, the sensitivity 66%, and the specificity 74%. Conclusion The left ventricular myocardial strain of IDCM and NIDCM patients are significantly decreased, and GRS could be used to help differentiate NIDCM from IDCM. |
| Key words: dilated cardiomyopathy ischemic cardiomyopathy echocardiography two-dimensional speckle tracking strain. |
