| 摘要: |
| 目的 探讨常规超声心动图联合三维斑点追踪技术（3D-STI）预测急性心肌梗死（AMI）患者经皮冠状动脉介入（PCI）术后主要不良心血管事件（MACE）的临床价值。方法 选取我院收治的AMI患者98例，根据PCI术后3个月内MACE发生情况分为MACE组和无MACE组。均于PCI术后24 h内行常规超声心动图和3D-STI检查，获取左心室收缩末内径（LVESd）、左心室射血分数（LVEF）、左心室舒张末内径（LVEDd）、左心室收缩末容积（LVESV）、左心室舒张末容积（LVEDV）、旋转角度、扭转角度、整体纵向应变（GLS）、整体面积应变（GAS）、整体圆周应变（GCS）、整体径向应变（GRS）。分析各参数与MACE发生的相关性，并对MACE预警因素进行重要性排序，绘制受试者工作特征（ROC）曲线分析各参数对MACE发生的预测效能。结果 MACE组LVEF、旋转角度、扭转角度、GLS、GAS、GCS、GRS均低于无MACE组，差异均有统计学意义（均P＜0.05），两组LVESd、LVEDd、LVESV、LVEDV比较，差异均无统计学意义。相关性分析显示，LVEF、旋转角度、扭转角度、GLS、GAS、GCS、GRS均与MACE呈负相关（均P＜0.05）；MACE预警因素的重要性排序依次为GLS、GRS、GAS、GCS、旋转角度、扭转角度、LVEF。ROC曲线分析显示，LVEF、旋转角度、扭转角度、GLS、GAS、GCS、GRS联合应用预测MACE发生的曲线下面积为0.914，均大于各参数单独应用（均P＜0.05）。结论 常规超声心动图联合3D-STI预测AMI患者PCI术后MACE发生具有一定的临床价值，可为临床早期判断PCI术后心功能损害提供重要依据。 |
| 关键词: 超声心动描记术 斑点追踪，三维 急性心肌梗死 经皮冠状动脉介入术 主要不良心血管事件 预测 |
| DOI： |
| 投稿时间：2023-12-21修订日期：2024-06-18 |
| 基金项目:安徽省淮北市淮北市科技项目 |
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| Study on the prediction efficiency and clinical significance of MACE after interventional operation of acute myocardial infarction by 2D + 3D ultrasonic spot tracking technique |
| Hu Deyun,Kang Lu,Wang Pan |
| () |
| Abstract: |
| Objective To investigate the changes in parameters of conventional echocardiography and three-dimensional speckle tracking imaging（3D-STI） in patients with acute myocardial infarction（AMI） after percutaneous coronary intervention（PCI），and analyze their predictive efficacy and clinical significance for the occurrence of major adverse cardiovascular events（MACE）.Methods A total of 98 patients with AMI admitted to our hospital were selected and divided into the MACE group and the non-MACE group according to the occurrence of MACE within 3 months after PCI. All patients underwent routine echocardiography and 3D-STI examination within 24 hours after PCI to obtain left ventricular end-systolic diameter (LVESd), left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDd), left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), rotation angle, torsion angle, global longitudinal strain (GLS), global area strain (GAS), global circumferential strain (GCS), and global radial strain (GRS). The correlation between each parameter and the occurrence of MACE was analyzed, and the importance of MACE warning factors was ranked. The receiver operating characteristic (ROC) curve was drawn to analyze the predictive efficacy of each parameter on the occurrence of MACE. Results The LVEF, rotation angle, torsion angle, GLS, GAS, GCS, and GRS in the MACE group were lower than those in the non-MACE group, and the differences were statistically significant (all P<0.05). There was no significant difference in LVESd, LVEDd, LVESV, and LVEDV between the two groups. Correlation analysis showed that LVEF, rotation angle, torsion angle, GLS, GAS, GCS, and GRS were negatively correlated with MACE (all P<0.05); the importance of MACE warning factors was ranked as follows: GLS, GRS, GAS, GCS, rotation angle, torsion angle, and LVEF. ROC curve analysis showed that the area under the curve for predicting the occurrence of MACE using LVEF, rotation angle, torsion angle, GLS, GAS, GCS, and GRS in combination was 0.914, which was greater than that of each parameter used alone (all P<0.05). Conclusion Patients with AMI who have MACE after PCI have decreased LVEF，rotation angle，torsion angle，GLS，GAS，GCS，and GRS.Combined detection of these parameters has certain predictive value for the occurrence of MACE，and may provide an important evaluation tool for early clinical diagnosis of cardiac function impairment after PCI. |
| Key words: Echocardiography speckle tracking, Three-dimensional acute myocardial infarction Percutaneous coronary intervention Major adverse cardiovascular events Prediction |
