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南方医科大学附属南海医院
纸质出版日期:2022,
网络出版日期:2022-7-5,
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宋势波. 超声形态学结合血清β2-微球蛋白和同型半胱氨酸评估扩张型心肌病患者心力衰竭风险的应用价值研究[J]. 临床超声医学杂志, 2022,24(6).
SONG Shi-bo. Application value study of ultrasound morphology combined with serum β2-microglobulin and homocysteine in evaluating the risk of heart failure in patients with dilated cardiomyopathy[J]. Journal of Clinical Ultrasound in Medicine, 2022,24(6).
宋势波. 超声形态学结合血清β2-微球蛋白和同型半胱氨酸评估扩张型心肌病患者心力衰竭风险的应用价值研究[J]. 临床超声医学杂志, 2022,24(6). DOI:
SONG Shi-bo. Application value study of ultrasound morphology combined with serum β2-microglobulin and homocysteine in evaluating the risk of heart failure in patients with dilated cardiomyopathy[J]. Journal of Clinical Ultrasound in Medicine, 2022,24(6). DOI:
目的 探讨超声形态学结合血清β2-微球蛋白(β2-MG)、同型半胱氨酸(Hcy)评估扩张型心肌病(DCM)患者心力衰竭(HF)风险的应用价值研究。方法 收集我院2017年5月至2020年11月就诊的86例DCM-HF患者,按纽约心脏病学会(NYHA)的心功能分级法,分为NYHA II级组(n=31)、NYHA III级组(n=26)、NYHA IV级组(n=29)。同时收集同期入院健康体检的30例志愿者作为对照组。所有纳入研究患者均行超声及血清β2-MG、Hcy检查,并收集记录临床资料。分析不同NYHA 分级的DCM-HF患者的超声形态学参数左室舒张末期容积(LVEDV)、左室舒张末期内径(LVEDD)、左室收缩末期容积(LVESV)、左室收缩末期内径(LVESD)、左心房内径(LAD)和血清β2-MG、Hcy水平差异。采用Spearman秩相关分析不同NYHA 分级的DCM-HF患者的超声形态学参数和血清β2-MG、Hcy水平的相关性。采用接受者操作特性曲线(ROC)分析超声形态学结合血清β2-MG、Hcy对DCM-HF的诊断价值。结果 Spearman相关性分析结果显示,超声形态学参数LVEDV、LVEDD、LVESV、LVESD、LAD与DCM-HF患者心功能分级严重程度呈正相关(r=0.524,P=0.000;r=0.607,P=0.000;r=0.536,P=0.000;r=0.462,P=0.000;r=0.650,P=0.000);血清β2-MG、Hcy水平与DCM-HF患者心功能分级严重程度呈正相关(r=0.637,P=0.000;r=0.720,P=0.000)。随着DCM-HF患者心功能分级严重程度增加,超声形态学参数LVEDV、LVEDD、LVESV、LVESD、LAD和血清β2-MG、Hcy水平逐渐升高,差异均有统计学意义(P<0.05)。超声形态学结合血清β2-MG、Hcy对DCM-HF的诊断效能最佳,AUC、敏感度、特异度、95%CI分别为0.89、0.81、0.90、0.87-0.95。结论 超声形态学参数及血清β2-MG、Hcy水平越高,DCM-HF心功能分级越严重,两者呈正相关;联合应用可评估患者危险分层,显著提高诊断效能,并为临床治疗提供参考依据。
Objective:To explore the application value of ultrasound morphology combined with serum β2-microglobulin (β2-MG) and homocysteine (Hcy) in evaluating the risk of heart failure (HF) in patients with dilated cardiomyopathy (DCM).Methods:A total of 86 patients with DCM-HF admitted to our hospital from May 2017 to November 2020 were collected and divided into NYHA grade II group (n=31)
NYHA grade III group (n=26)
and NYHA grade IV group (n=29) according to the cardiac function grading method of New York College of Cardiology (NYHA). At the same time
30 healthy volunteers who were admitted to hospital during the same period were collected as the control group. All patients were examined by ultrasonography
serum β2-MG and Hcy
and clinical data were collected and recorded. The morphological parameters of left ventricular end-diastolic volume (LVEDV)
left ventricular end-diastolic diameter (LVEDD)
left ventricular end-systolic volume (LVESV)
left ventricular end-systolic diameter (LVESD)
left atrial diameter (LAD)
and serum β2-Mg and Hcy levels in DCM-HF patients with different NYHA grades were analyzed. Spearman rank correlation was used to analyze the correlation between ultrasonic morphological parameters and serum β2-MG and Hcy levels in DCM-HF patients with different NYHA grades.. Receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of ultrasonic morphology combined with serum β2-MG and Hcy for DCM-HF. Results:Spearman correlation analysis results showed that ultrasound morphological parameters LVEDV
LVEDD
LVESV
LVESD
LAD were positively correlated with the severity of cardiac function grading in patients with DCM-HF (r = 0.524
P=0.000;R=0.607
P=0.000;R=0.536
P=0.000;R=0.462
P=0.000;R=0.650
P=0.000);Serum β2-MG and Hcy levels were positively correlated with the severity of cardiac function grading in patients with DCM-HF (r=0.637
P=0.000;R=0.720
P=0.000). As the severity of cardiac function grading in DCM-HF patients increased
ultrasound morphological parameters LVEDV
LVEDD
LVESV
LVESD
LAD and serum β2-MG and Hcy levels gradually increased
with statistical significance (P<0.05). Ultrasonographic morphology combined with serum β2-MG and Hcy had the best diagnostic efficacy for DCM-HF. AUC
sensitivity
specificity and 95%CI were 0.89
0.81
0.90
0.87-0.95
respectively. Conclusion:The higher the ultrasonic morphological parameters and serum β2-MG and Hcy levels were
the more serious the DCM-HF cardiac function grade was
and the two were positively correlated. Combined application can assess the risk stratification of patients
significantly improve the diagnostic efficiency
and provide a reference for clinical treatment.
超声形态学β2-微球蛋白同型半胱氨酸扩张型心肌病心力衰竭诊断价值
Ultrasonic morphologyβ2-microglobulinHomocysteineDilated cardiomyopathycardiac failureDiagnostic value
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