临床及超声诊断冠心病乳头肌功能失调对比

韩娟娟

[关键词] 冠心病;乳头肌功能失调;临床诊断;超声诊断;诊断精准度

[中图分类号] R541.4          [文献标识码] B          [文章编号] 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

乳頭肌功能失调（Papillary muscle dysfunction，PMD）是冠心病（Coronary heart disease，CHD）患者的主要并发症，指房室瓣相连的乳头肌出现坏死和缺血改变，进而导致乳头肌收缩障碍，这会造成房室瓣无法完全关闭，加重冠脉缺血情况。PMD会降低心脏功能，增加其他并发症的发病风险，而且会影响CHD的治疗预后[1-2]。临床要求尽早诊断CHD-PMD，评估患者的病情程度，予以及时干预，进而阻断CHD疾病进展。其常用的诊断方法为临床诊断，可通过症状与体征诊断鉴别患者的病情严重程度，提高疾病阳性检出率。但是临床诊断具有局限性，其缺乏影像学技术支持。为此，多加用超声诊断，以增强诊断准确率。本研究选取2018年11月至2020年11月间入院诊断的CHD-PMD患者89例，用于分析超声诊断与临床诊断的价值，现报道如下。