臨床及超聲診斷冠心病乳頭肌功能失調對比

韓娟娟

[關鍵詞] 冠心病;乳頭肌功能失調;臨床診斷;超聲診斷;診斷精準度

[中圖分類號] R541.4? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）21-0100-03

Comparison of clinical and ultrasonic diagnosis of coronary heart disease with papillary muscle dysfunction

HAN Juanjuan

Department of Ultrasound，Zaozhuang Hospital of Traditional Chinese Medicine，Shandong，Zaozhuang? ?277100，China

[Abstract] Objective To analyze the value of clinical diagnosis and ultrasonic diagnosis in coronary heart disease （CHD） with papillary muscle dysfunction （PMD）.Methods A total of 89 CHD-PMD patients diagnosed and treated from November 2018 to November 2020 were selected.Clinical diagnosis and ultrasonic diagnosis were carried out，and the diagnostic value of the two methods was compared. Results The rate of intermittent dyspnea at night was 78.65% by ultrasonic and 70.79% by clinical diagnosis.The rate of shortness of breath and palpitation was 77.53% by ultrasonic diagnosis and 71.91% by clinical diagnosis.The probability of lung rales was 74.16% by ultrasonic diagnosis and 67.42% by clinical diagnosis.The probability of left enlargement of cardiac boundary was 80.90% by ultrasonic diagnosis and 71.91% by clinical diagnosis，with no significant differences （P>0.05）. The positive rate of ultrasonic diagnosis was 86.52%，and that of clinical diagnosis was 71.91%.According to the pathological diagnosis certificate，the sensitivity of ultrasonic diagnosis was 97.33%，and that of clinical diagnosis was 74.24%.The specificity of ultrasonic diagnosis was 71.43%，and that of clinical diagnosis was 34.78%. The accuracy of ultrasonic diagnosis was 93.26%，and that of clinical diagnosis was 64.04%，with statistically significant differences （P<0.05）.The duration from onset to diagnosis was （1.29±0.84） months by ultrasonic diagnosis and （5.88±0.92） months by clinical diagnosis，with statistically significant difference （P<0.05）. Conclusion The accuracy of ultrasound in the diagnosis of CHD-PMD is significantly better than that of clinical diagnosis.These two methods show the similar diagnostic effect on clinical manifestations.Ultrasound examination can be carried out on the basis of clinical diagnosis to enhance the diagnostic effect.

[Key words] Coronary heart disease;Papillary muscle dysfunction;Clinical diagnosis;Ultrasonic diagnosis;Diagnostic accuracy

乳頭肌功能失調（Papillary muscle dysfunction，PMD）是冠心病（Coronary heart disease，CHD）患者的主要并發癥，指房室瓣相連的乳頭肌出現壞死和缺血改變，進而導致乳頭肌收縮障礙，這會造成房室瓣無法完全關閉，加重冠脈缺血情況。PMD會降低心臟功能，增加其他并發癥的發病風險，而且會影響CHD的治療預后[1-2]。臨床要求盡早診斷CHD-PMD，評估患者的病情程度，予以及時干預，進而阻斷CHD疾病進展。其常用的診斷方法為臨床診斷，可通過癥狀與體征診斷鑒別患者的病情嚴重程度，提高疾病陽性檢出率。但是臨床診斷具有局限性，其缺乏影像學技術支持。為此，多加用超聲診斷，以增強診斷準確率。本研究選取2018年11月至2020年11月間入院診斷的CHD-PMD患者89例，用于分析超聲診斷與臨床診斷的價值，現報道如下。