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目的研究探讨三维斑点追踪技术于静息条件下在冠心病患者早期诊断中的价值和临床意义。方法对110例可疑冠心病的患者行三维斑点追踪技术(3D-STE)和冠脉造影术(CAG),依据造影结果将患者分为冠心病组和正常组。利用3D-STE技术,得到患者左室心肌各应变的峰值和达峰时间:即纵向、环形、径向、面积应变峰值(LS、CS、RS、AS);纵向、环形、径向、面积应变达峰时间(T-LS、T-CS、T-RS、T-AS)。运用Logistic二元回归分析将各应变峰值和达峰时间指标联合,本研究定义为纵向、环形、径向、面积应变复合指标(LS1、CS1、RS1、AS1)。对上述12项指标采用受试者工作特征曲线(ROC)分析。结果 ROC曲线分析结果示,纵向应变达峰时间(T-LS)和复合指标LS1、CS1、AS1在冠心病的早期诊断中有一定价值,且它们的曲线下面积(AUC)分别为0.667、0.692、0.621、0.672(P<0.005)。其中复合指标LS1诊断价值最高,灵敏度及特异度分别为62%、76%。结论 3D-STE在患者静息条件下对早期冠心病的诊断具有一定的价值,其中纵向应变复合指标LS1灵敏度最高。
Objective To investigate the value and clinical significance of three-dimensional speckle tracking in early diagnosis of patients with coronary heart disease under resting conditions. Methods One hundred and ten patients with suspected coronary heart disease underwent three-dimensional speckle tracking (3D-STE) and coronary angiography (CAG). Patients were divided into coronary heart disease group and normal group according to the angiographic results. The peak and peak time of each strain in left ventricular myocardium were obtained by 3D-STE technique: longitudinal, annular, radial and area strain peaks (LS, CS, RS and AS); longitudinal, annular, radial and area strain Peak time (T-LS, T-CS, T-RS, T-AS). Logistic bivariate regression analysis was used to combine the peak and peak time of each strain. The study was defined as the composite index of longitudinal, circular, radial and area strain (LS1, CS1, RS1, AS1). Subjects operating characteristic curve (ROC) analysis was performed on the above 12 indicators. Results The results of ROC curve analysis showed that T-LS and composite indices LS1, CS1 and AS1 were valuable in the early diagnosis of coronary heart disease, and the areas under the curve (AUC) were 0.667 and 0.692, respectively , 0.621, 0.672 (P <0.005). Among them, compound LS1 has the highest diagnostic value, sensitivity and specificity of 62% and 76% respectively. Conclusions 3D-STE is valuable in the diagnosis of early-stage coronary heart disease under resting conditions. The sensitivity of longitudinal strain composite index LS1 is the highest.