摘要
目的:研究心脏彩色超声联合心踝血管指数(CAVI)和踝臂指数(ABI)用于冠心病早期诊断的价值.方法:选取2019年12月至2022年12月乐山市人民医院收治的146例冠心病患者,将其纳入观察组,另将同期在医院体检的70名正常体检者纳入健康对照组.两组受试者均行心脏彩色超声并检测CAVI、ABI,比较两组心肌做功指数(Tei指数)、舒张期E峰血流速度(E)与舒张晚期A峰血流速度(A)比值(E/A)、左心房内径(LAD)、左心室射血分数(LVEF)、CAVI以及ABI水平;绘制受试者工作特征(ROC)曲线,分析Tei指数、E/A、LAD、LVEF、CAVI及ABI单独诊断冠心病的价值;以冠状动脉造影结果为"金标准",以一致性Kappa检验分析Tei指数、E/A、LAD、LVEF、CAVI及ABI联合诊断冠心病的效能.结果:观察组Tei指数、LVEF及CAVI水平明显高于健康对照组,差异有统计学意义(t=19.357、25.728、21.766,P＜0.05),E/A、LAD及ABI水平明显低于健康对照组,差异有统计学意义(t=7.721、2.769、10.610,P＜0.05).经ROC分析证实Tei指数、E/A、LAD、LVEF、CAVI及ABI能够用于诊断冠心病,ROC曲线下面积分别为0.914、0.796、0.553、0.950、0.930和0.834.经一致性Kappa检验分析,Tei指数、E/A、LAD、LVEF、CAVI及ABI联合诊断冠心病的灵敏度为98.6%,特异度为92.9%,准确率为96.8%(Kappa=0.925,P＜0.05).结论:Tei指数、E/A、LAD、LVEF、CAVI及ABI可用于诊断冠心病,且联合诊断的效能更高.
Abstract
Objective:To investigate the value of cardiac color ultrasound combined with cardiac ankle vascular index(CAVI)and ankle brachial index(ABI)in the early diagnosis of coronary heart disease.Methods:A total of 146 patients with coronary heart disease admitted to Leshan People's Hospital from December 2019 to December 2022 were included in the observation group,and 70 healthy persons who underwent physical examination in the hospital during the same period were included in the healthy control group.Both groups underwent cardiac color ultrasound and the examinations of CAVI and ABI.Myocardial performance index(Tei index),ratio of diastolic peak E velocity(E)to late diastolic peak A velocity(A)(E/A),left atrial diameter(LAD),left ventricular ejection fraction(LVEF),CAVI and ABI levels were compared between the two groups.Receiver operating characteristic(ROC)curve was plotted to analyze the values of Tei index,E/A,LAD,LVEF,CAVI and ABI in the alone diagnosis of coronary heart disease.The result of coronary angiography was used as the gold standard,and the consistency was used to analyze the efficacy of the combined diagnosis of Tei index,E/A,LAD,LVEF,CAVI and ABI coronary heart disease.Results:The Tei index,LVEF and CAVI levels in the observation group were significantly higher than those in the healthy control group(t=19.357,25.728,21.766,P<0.05),and the E/A,LAD and ABI levels in the observation group were significantly lower than those in the healthy control group(t=7.721,2.769,10.610,P<0.05),respectively.The ROC analysis proved that Tei index,E/A,LAD,LVEF,CAVI and ABI could be used to diagnose coronary heart disease.The areas under curve(AUC)values of them were 0.914,0.796,0.553,0.950,0.930 and 0.834,respectively.The result of consistency analysis indicated that the sensitivity,specificity,accuracy and Kappa value of the combined diagnosis of Tei index,E/A,LAD,LVEF,CAVI and ABI were respectively 0.986,0.929,0.968 and[0.925(P<0.05)]in diagnosing coronary heart disease.Conclusion:Tei index,E/A,LAD,LVEF,CAVI and ABI can be used to diagnose coronary heart disease,and the combined diagnosis of them has higher efficiency.
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