摘要
目的 探讨超声心动图在心力衰竭(HF)中的诊断及预测价值.方法 回顾性选取 2021 年 7 月至2023 年 7 月我院收治的 74 例HF患者为观察组,根据 1∶1 选例原则,另选取同期 74 名健康体检者为对照组,均行超声心动图检查.比较 2 组及不同预后患者超声心动图参数[左室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左房整体射血分数(LAEF)、左房每搏量(LASV)、舒张末期左室后壁厚度(LVPWd)、收缩末期左室后壁厚度(LVPWs)],分析超声心动图参数对HF的诊断价值,并分析其对预后的预测价值.结果 观察组超声心动图参数LVEF、LAEF、LASV值小于对照组,LVEDD、LVPWd、LVPWs值大于对照组(P<0.05);预后不良患者LVEF、LAEF、LASV值小于预后良好患者,LVEDD、LVPWd、LVPWs值大于预后良好患者(P<0.05);LVEF、LAEF、LASV、LVEDD、LVPWd、LVPWs联合诊断HF的曲线下面积(AUC)为 0.90,灵敏度为 89%,特异度为 86%,约登指数为0.76,联合预测预后不良的AUC为 0.88,灵敏度为 90%,特异度为 83%,约登指数为 0.74(P<0.05).结论 超声心动图参数与HF发生密切相关,各参数联合检测对HF具有一定诊断价值,且对预后不良具有一定预测价值,可作为临床诊断HF、预测预后的有效检查指标.
Abstract
Objective To investigate the diagnostic and predictive value of echocardiography in heart failure(HF).Methods A total of 74 patients with HF admitted to our hospital from July 2021 to July 2023 were retrospectively selected as the observation group,and 74 healthy subjects were selected as the control group according to the principle of 1:1 case selection,and echocardiography was performed.The echocardiographic parameters[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left atrial ejection fraction(LAEF),left atrial stroke volume(LASV),left ventricular posterior wall thickness at end-diastole(LVPWd),and left ventricular posterior wall thickness at end-systole(LVPWs)]were compared between the two groups and among patients with different prognoses,and the diagnostic value of echocardiographic parameters for HF was analyzed.The predictive value of echocardiographic parameters for prognosis was also analyzed.Results The values of LVEF,LAEF,and LASV in the observation group were lower than those in the control group,and the values of LVEDD,LVPWd,and LVPWs were higher than those in the control group(P<0.05).The LVEF,LAEF,LASV values of patients with poor prognosis were lower than those of patients with good prognosis,and the LVEDD,LVPWd,and LVPWs values were higher than those of patients with good prognosis(P<0.05).The AUC of LVEF,LAEF,LASV,LVEDD,LVPWd,and LVPWs for the combined diagnosis of HF was 0.90,with an optimal sensitivity of 89%,an optimal specificity of 86%,and a Youden index of 0.76.The AUC for combined prediction of poor prognosis was 0.88,with an optimal sensitivity of 90%,an optimal specificity of 83%,and a Youden index of 0.74(P<0.05).Conclusion Echocardiographic parameters are closely related to the occurrence of HF,and combined detection of various parameters has certain diagnostic value for HF,as well as certain predictive value for poor prognosis.It can be used as an effective examination indicator for clinical diagnosis of HF and prediction of prognosis.
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