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目的:探讨双源64层螺旋CT结合心肌营养素-1对于舒张期心衰的诊断价值。方法:选择2014年10月~2016年10月在河北省三河市医院诊断舒张期心衰患者60例作为研究组,同期选择不稳定心绞痛患者60例作为对照组。入院后24h内给予酶联免疫吸附法检测血浆营养素-1(CT-1),双抗体免疫荧光法检查血浆氨基末端钠尿肽(NT-pro BNP)水平,采用64层双源螺旋CT(64-MDCT)行冠状动脉血管成像,利用左室功能评估软件在左心室长、短轴方向勾勒左心室内膜面,计算左心室舒张末期容积(LVEDV)、收缩末期容积(LVESV),测量二尖瓣口舒张早期、晚期血流速度峰值(E、A),二尖瓣舒张早期最大组织运动速度(Ea),计算E/A、E/Ea比值。比较2组患者血浆CT-1、BNP水平以及影像学指标差异。Spearman相关分析比较血浆CT-1、BNP、E/Ea比值间相关性。采用受试者工作特征曲线(ROC)分析血浆CT-1与E/Ea比值对于舒张期心衰诊断的预测价值。结果:研究组与对照组比较,血浆CT-1、NT-pro BNP、E/Ea比值水平明显升高,E/A比值降低,2组比较差异有统计学意义。LVEDV、LVESV指标差异无统计学意义。血浆CT-1、E/Ea与BNP比值之间呈直线正相关。2组患者64-MDCT检测左室舒张功能各指标略高于M型超声心动图对应指标,但差异无统计学意义。两种不同检查方法心脏功能各指标高度相关。血浆CT-1以71.5 pg/m L,E/Ea比值>8.0为截断值,预测舒张期心衰诊断的灵敏度为(68.79%,86.34%),特异度为(65.29%,89.02%)。ROC曲线下面积分为。结论:双源64层螺旋CT可用于舒张期心衰的定量评价,其E/Ea比值、血浆心肌营养素-1与氨基末端脑钠尿肽水平存在较好相关性。E/Ea比值与血浆心肌营养素-1水平升高对于舒张期心衰具有一定诊断价值。
Objective: To investigate the diagnostic value of dual-source 64-slice spiral CT combined with cardiotrophin-1 for diastolic heart failure. Methods: From October 2014 to October 2016, 60 patients with diastolic heart failure diagnosed in Sanhe Hospital of Hebei Province were selected as the study group, and 60 patients with unstable angina pectoris were selected as the control group in the same period. Plasma samples were collected for detection of plasma neutrophil-1 (CT-1) by enzyme-linked immunosorbent assay (ELISA) within 24 hours after admission. Plasma NT-proBNP was detected by double antibody immunofluorescence. (Left ventricular end-diastolic dimension), left ventricular end-diastolic volume (LVEDV) and end-systolic volume (LVESV) were calculated by left ventricular function evaluation software in the long and short axis of the left ventricle. The values of E / A and E / Ea were calculated from the early diastole and the late peak velocities (E, A) and the maximal mitral diastolic early diastolic velocity (Ea). The plasma levels of CT-1 and BNP in two groups were compared, and the difference of imaging indexes was compared. Spearman correlation analysis of plasma CT-1, BNP, E / Ea ratio between the correlation. Predictive value of plasma CT-1 and E / Ea ratio in predicting diastolic heart failure was analyzed using receiver operating characteristic curve (ROC). Results: Compared with the control group, the plasma levels of CT-1, NT-pro BNP and E / Ea were significantly increased and the E / A ratio was decreased. The difference between the two groups was statistically significant. LVEDV, LVESV index difference was not statistically significant. There was a linear positive correlation between plasma CT-1, E / Ea and BNP. The indexes of left ventricular diastolic function detected by 64-MDCT in 2 groups were slightly higher than those of M-mode echocardiography, but the difference was not statistically significant. Two different methods of examinations of cardiac function are highly correlated with each other. The sensitivity and specificity of plasma CT-1 in diagnosing diastolic heart failure were 71.5 pg / m L and> 8.0, respectively. The sensitivity and specificity of CT-1 in diagnosing diastolic heart failure were 68.79% and 86.34%, and specificity was 65.29% and 89.02% respectively. The area under the ROC curve is divided into. Conclusion: Dual-source 64-slice spiral CT can be used to evaluate diastolic heart failure. E / Ea ratio, plasma cardiotrophin-1 and amino terminal brain natriuretic peptide are correlated well. E / Ea ratio and plasma cardiotrophin-1 levels for diastolic heart failure has a certain diagnostic value.