二维斑点追踪分层应变参数联合白细胞衍生炎症指标对冠心病的诊断价值

刘家佳; 张璐; 张艳; 杨梦琪; 安景景; 邓爱云

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二维斑点追踪分层应变参数联合白细胞衍生炎症指标对冠心病的诊断价值

临床研究 | 更新时间：2023-10-11

- 二维斑点追踪分层应变参数联合白细胞衍生炎症指标对冠心病的诊断价值
- Diagnostic value of layered ultrasound strain parameter combined with leukocyte-associated inflammation indices in coronary heart disease
- 临床超声医学杂志 2023年25卷第4期
- 作者机构：
  
  1. 兰州大学第一临床医学院
  2. 兰州大学第一医院
- 作者简介：
- 基金信息：
  
  甘肃省自然科学基金资助项目(20JR10RA679)，兰大一院院内基金(ldyyyn2019-63)
- DOI：
  中图分类号：
- 纸质出版日期：2023，
  
  网络出版日期：2023-4-28，
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刘家佳, 张璐, 张艳, 等. 二维斑点追踪分层应变参数联合白细胞衍生炎症指标对冠心病的诊断价值[J]. 临床超声医学杂志, 2023,25(4).

Diagnostic value of layered ultrasound strain parameter combined with leukocyte-associated inflammation indices in coronary heart disease[J]. Journal of Clinical Ultrasound in Medicine, 2023,25(4).
刘家佳, 张璐, 张艳, 等. 二维斑点追踪分层应变参数联合白细胞衍生炎症指标对冠心病的诊断价值[J]. 临床超声医学杂志, 2023,25(4). DOI：

Diagnostic value of layered ultrasound strain parameter combined with leukocyte-associated inflammation indices in coronary heart disease[J]. Journal of Clinical Ultrasound in Medicine, 2023,25(4). DOI：

摘要

目的分析冠状动脉粥样硬化性心脏病（CAD）患者二维斑点追踪分层应变参数与白细胞衍生炎症指标的相关性，探讨二者联合在CAD诊断中的应用价值。方法选取我院因胸痛行冠状动脉造影疑诊为CAD患者141例（CAD组），根据冠状动脉狭窄程度分为：轻度狭窄组（47例），中度狭窄组（53例）及重度狭窄组（41例），另选同期健康体检者30例为对照组。收集受试者实验室检查结果计算淋巴细胞与单核细胞比值（LMR）、单核细胞与高密度脂蛋白-胆固醇比值（MHR）；应用二维斑点追踪分层应变技术获得左室心内膜下、中层、心外膜下心肌整体纵向应变（GLSendo、GLSmid、GLSepi）。比较各组上述参数的差异，采用Spearman相关分析法分析LMR、MHR与各分层应变参数的相关性，绘制受试者工作特征（ROC）曲线分析LMR、MHR及GLSendo单独及联合应用诊断CAD的效能，采用组内相关系数（ICC）评价观察者内及观察者间对各分层应变参数的一致性。结果与对照组比较，轻、中、重度狭窄组LMR均减低，MHR均升高，轻度狭窄组GLSendo、GLSmid均减低，中、重度狭窄组GLSendo、GLSmid、GLSepi均减低，差异均有统计学意义（均P＜0.05）。相关性分析显示，MHR与GLSendo、GLSmid及GLSepi均呈正相关（r=0.382、0.384、0.366，均P＜0.05），LMR与GLSendo、GLSmid及GLSepi均呈负相关（r=-0.198、-0.231、-0.249，均P＜0.05）。ROC曲线分析显示，LMR、MHR联合GLSendo诊断CAD的曲线下面积分别为0.791、0.858（均P＜0.001）。一致性检验显示，各分层应变参数在观察者间和观察者内的一致性均良好（ICC均＞0.8）。结论二维斑点追踪分层应变参数与白细胞衍生炎症指标具有相关性，LMR、MHR联合GLSendo对CAD有一定的诊断价值。

Abstract

Objective To analyze the correlation between two-dimensional speckle tracking layer-specfic strain parameters and leukocyte-associated inflammatory indexes in patients with coronary artery disease (CAD)

and to explore the application value of the combination of the two in CAD diagnosis. Methods A total of 141 patients with suspected CAD (CAD group) who underwent coronary angiography due to chest pain in our hospital were selected

and according to the degree of coronary artery stenosis

they were divided into mild stenosis group (47 cases)

moderate stenosis group (53 cases) and severe stenosis group (41 cases)

and 30 healthy physical examination patients in the same period were selected as the control group.Collect the results of laboratory tests to calculate the ratio of lymphocytes to monocytes (LMR) and monocytes to high-density lipoprotein-cholesterol (MHR)

The two-dimensional speckle tracking layer-specfic strain imaging was used to obtain the overall longitudinal strain of the left ventricular subendocardial

middle and subepicardial myocardium (GLSendo

GLSmid

GLSepi). The differences of the above parameters were compared

the correlation between LMR

MHR and each layer-specfic parameter was analyzed by Spearman correlation analysis

and the ROC curve of the subject was drawn to analyze the performance of LMR

MHR and GLSendo in diagnostic CAD alone and in combination. The intra-group correlation coefficient (ICC) was used to evaluate the consistency of strain parameters within and between observers. Results Compared with the control group

LMR and MHR were reduced in the mild

moderate and severe stenosis groups

GLSendo and GLSmid were reduced in the mild stenosis group

and GLSendo

GLSmid and GLSepi were reduced in the moderate and severe stenosis groups

and the differences were statistically significant (all P<0.05). Conclusions The two-dimensional speckle tracking layer-specfic strain parameters are correlated with leukocyte-associated inflammation indexes

and LMR

MHR combined with GLSendo have certain diagnostic value in CAD.

关键词

超声心动描记术斑点追踪分层应变冠状动脉粥样硬化性心脏病炎症指标

Keywords

EchocardiographySpeckle trackingLayer-specific strainCoronary artery diseaseinflammation marker

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