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四维超声自动左心房定量技术对糖尿病肾病患者心血管并发症的预测价值研究 |
文雅,郑小叶,刘韦华,谢晴,周琦 |
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(西安交通大学第二附属医院医用超声研究室;西安市第三医院超声科) |
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摘要: |
目的 四维超声自动左心房定量技术(4D-LAQ)对糖尿病肾病患者心血管并发症的预测价值。方法 选取2022年3月~2023年12月本院收治的糖尿病肾病患者120例,根据是否发生心血管并发症,分为并发心血管疾病组(n=51)和无并发心血管疾病组(n=69)。另选取同期50例健康体检患者作为对照组。比较各组间一般资料及常规超声心动图参数和4D-LAQ参数差异,以及各参数对糖尿病肾病发生心血管并发症的诊断效能。结果 并发心血管疾病组和无并发心血管疾病组中LVEDD、LAD、LVEF、LVESD和E/A均和对照组具有显著性差异(P<0.05),并发心血管疾病组中LVEDD、LAD、LVEF、LVESD和无并发心血管疾病组具有显著性差异(P<0.05);并发心血管疾病组和无并发心血管疾病组中LAVmax、LAVmin、LAVImax、LAVpreA、LAEF、LASct、LAScd、LASr、4D-GRPS和4D-GLPS均和对照组具有显著性差异(P<0.05),并发心血管疾病组LAVmax、LAVmin、LAVImax、LAVpreA、LAEF、LASct、LAScd、LASr、4D-GRPS和4D-GLPS和无并发心血管疾病组具有显著性差异(P<0.05);并发心血管疾病组患者LVEDD、LAD与LAVmax、LAVmin、LAVImax、LAVpreA、LAScd和4D-GLPS呈正相关(P<0.05),与LAEF、LASct、LASr和4D-GRPS呈负相关(P<0.05),LVESD、LVEF与LAVmax、LAVmin、LAVImax、LAVpreA、LAScd和4D-GLPS呈负相关(P<0.05),与LAEF、LASct、LASr和4D-GRPS呈正相关(P<0.05);ROC曲线显示,常规超声参数LVEDD、LAD、LVESD和LVEF的AUC分别为0.718、0.693、0.610和0.497,4D-LAQ参数LAVmax、LAVmin、LAVImax、LAVpreA、LAEF、LASct、LAScd、LASr、4D-GRPS和4D-GLPS的AUC分别为0.764、0.649、0.778、0.649、0.666、0.895、0.776、0.697、0.842和0.865。结论 四维超声自动左心房定量技术可以有效评估糖尿病肾病患者左心房容积和功能变化,对于评估糖尿病肾病患者心血管并发症具有较高预测价值。 |
关键词: 四维超声自动左心房定量技术 糖尿病肾病 心血管并发症 预测价值 |
DOI: |
投稿时间:2024-06-05修订日期:2024-08-15 |
基金项目:陕西省重点研发计划项目S2022-YF-YBSF-0983 |
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Predictive value of four-dimensional automatic left atrial quantification on cardiovascular complications in patients with diabetic nephropathyWen.Ya1 Zheng.XiaoYe1 Liu.WeiHua1 Xie.Qing1 Zhou.Qi2* |
wenya,zhengxiaoye,liuweihua,xieqing,zhouqi |
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Abstract: |
Objective To evaluate the predictive value of four-dimensional automatic left atrial quantification (4D-LAQ) on cardiovascular complications in patients with diabetic nephropathy (DN). Methods 120 patients with DN in the hospital were selected from March 2022 to December 2023. According to whether cardiovascular complications occurred, they were divided into cardiovascular disease group (n=51) and non-cardiovascular disease group (n=69). Another 50 healthy subjects with physical examination during the same period were included in control group. The general data and conventional echocardiographic parameters [left ventricular end-diastolic diameter (LVEDD), left atrial anteroposterior diameter (LAD), left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESD), early diastolic peak velocity of mitral annulus (E/A)] and 4D-LAQ parameters [maximum left atrial volume (LAVmax), minimum left atrial volume (LAVmin), maximum left atrial volume index (LAVImax), left atrial pre-systolic volume (LAVpreA), left atrial total emptying fraction (LAEF), left atrial systolic longitudinal strain (LASct), left atrial conduit longitudinal strain (LAScd) and left atrial reserve longitudinal strain (LASr)] were compared among the groups. The correlation between left atrial strain parameters and volume parameters and the diagnostic efficiency of each parameter on cardiovascular complications in DN were analyzed. Results There were significant differences in LVEDD, LAD, LVEF, LVESD and E/A in cardiovascular disease group and non-cardiovascular disease group compared with those in control group (P<0.05). Significant differences were shown in LVEDD, LAD, LVEF and LVESD between cardiovascular disease group and non-cardiovascular disease group (P<0.05). The LAVmax, LAVmin, LAVImax, LAVpreA, LAEF, LASct, LAScd, LASr, 4D-GRPS and 4D-GLPS in cardiovascular disease group and non-cardiovascular disease group were obviously different from control group (P<0.05), and the above parameters between cardiovascular disease group and non-cardiovascular disease group were significantly different (P<0.05). Pearson correlation analysis showed that LVEDD and LAD in cardiovascular disease group were positively correlated with LAVmax, LAVmin, LAVImax, LAVpreA, LAScd and 4D-GLPS(P<0.05), and were negatively correlated with LAEF, LASct, LASr and 4D-GRPS(P<0.05). LVESD and LVEF were negatively correlated with LAVmax, LAVmin, LAVImax, LAVpreA, LAScd and 4D-GLPS(P<0.05), and were positively correlated with LAEF, LASct, LASr and 4D-GRPS(P<0.05). ROC curve revealed that the AUCs of 4D-LAQ parameters LAVmax, LAVmin, LAVImax, LAVpreA, LAEF, LASct, LAScd, LASr, 4D-GRPS和4D-GLPS were 0.764, 0.649, 0.778, 0.649, 0.666, 0.895, 0.776, 0.697, 0.842 and 0.865 respectively. The AUCs of conventional ultrasound parameters LVEDD, LAD, LVESD and LVEF were 0.718, 0.693, 0.610 and 0.497 respectively. Conclusion Four-dimensional automatic left atrial quantification can effectively evaluate the changes of left atrial volume and function in patients with DN, and has a high predictive value on evaluating cardiovascular complications in patients with DN. |
Key words: Four-dimensional automatic left atrial quantification Diabetic nephropathy Cardiovascular complications Predictive value |
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