摘要
目的 探讨四维自动左房定量技术(4D-LAQ)评估糖尿病肾病患者心功能障碍的临床价值.方法 选取我院收治的糖尿病肾病患者120例,根据是否合并心功能障碍分为心功能障碍组51例和无心功能障碍组69例,另选同期健康体检者50例为对照组,比较各组4D-LAQ参数包括左房最大和最小容积(LAVmax、LAVmin)、容积最大指数(LAVImax)、收缩前容积(LAVpreA)、总排空分数(LAEF)、收缩期纵向应变(LASct)、管道期纵向应变(LAScd)、储备期纵向应变(LASr)、整体径向应变(4D-GRPS)和整体纵向应变(4D-GLPS)的差异.绘制受试者工作特征(ROC)曲线分析4D-LAQ参数评估糖尿病肾病患者心功能障碍的诊断效能.结果 与对照组比较,心功能障碍组和无心功能障碍组LAVmax、LAVmin、LAVImax、LAVpreA均增高,LAEF、LASct、LAScd、LASr、4D-GLPS、4D-GRPS均减低,差异均有统计学意义(均P<0.05);与无心功能障碍组比较,心功能障碍组LAVmax、LAVmin、LAVImax、LAVpreA均增高,LAEF、LASct、LAScd、LASr、4D-GLPS、4D-GRPS均减低,差异均有统计学意义(均P<0.05).ROC曲线分析显示,LAVmax、LAVmin、LAVImax、LAVpreA、LAEF、LASct、LAScd、LASr、4D-GRPS和4D-GLPS评估糖尿病肾病患者心功能障碍的曲线下面积分别为0.764、0.649、0.778、0.649、0.666、0.632、0.776、0.697、0.842和0.865.结论 4D-LAQ在评估糖尿病肾病患者心功能障碍中具有较高的临床价值.
Abstract
Objective To explore the clinical value of four-dimensional automatic left atrial quantification(4D-LAQ)in evaluating cardiac dysfunction in patients with diabetic nephropathy(DN).Methods Totally 120 patients with DN treated in our hospital were selected.According to whether cardiac dysfunction occurred,they were divided into cardiac dysfunction group(51 cases)and non-cardiac dysfunction group(69 cases).Another 50 healthy subjects underwent physical examination during the same period were enrolled as control group.The differences in 4D-LAQ parameters,including left atrial maximum and minimum volume(LAVmax,LAVmin),maximum volume index(LAVImax),pre-systolic volume(LAVpreA),total emptying fraction(LAEF),systolic longitudinal strain(LASct),longitudinal strain during pipeline phase(LAScd),longitudinal strain during reserve phase(LASr),overall radial strain(4D-GRPS),and overall longitudinal strain(4D-GLPS)were compared among groups.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of 4D-LAQ parameters in evaluating cardiac dysfunction in DN patients.Results Compared with control group,LAVmax,LAVmin,LAVImax,LAVpreA were increased in cardiac dysfunction group and non-cardiac dysfunction group,while LAEF,LASct,LAScd,LASr,4D-GLPS,4D-GRPS were decreased,the differences were statistically significant(all P<0.05).Compared with non-cardiac dysfunction group,LAVmax,LAVmin,LAVImax,LAVpreA in cardiac dysfunction group were increased,while LAEF,LASct,LAScd,LASr,4D-GLPS,4D-GRPS were decreased,the differences were statistically significant(all P<0.05).ROC curve analysis showed that the AUC of LAVmax,LAVmin,LAVImax,LAVpreA,LAEF,LASct,LAScd,LASr,4D-GRPS and 4D-GLPS in evaluating cardiac dysfunction in patients with DN were 0.764,0.649,0.778,0.649,0.666,0.632,0.776,0.697,0.842 and 0.865,respectively.Conclusion 4D-LAQ has high clinical value in evaluating cardiac dysfunction in patients with DN.
NETL
NSTL
万方数据