收缩后收缩参数联合定量血流比率预测ST段抬高型 心肌梗死患者PCI术预后的临床价值

打开文本图片集

ABSTRACTObjectiveTo investigate the clinical value postsystolic shortening（PSS）parameters combined with quantitative flowratio（QFR）inpredicting the prognosis ST-segment elevation myocardialinfarction（STEMI）patientsafter percutaneous coronary intervention（PCI）.MethodsAtotal104 STEMI patients whounderwentPCIinour hospital were enroled.Two-dimensionalspeckletrackingechocardiographywasperformedwithin24-48hafterPCItoobtainleftventricular PSS parameter［global postsystolic index（PSI）]，earlysystolic lengthening parameter［global early systolic index（ESI）]and globalongitudinal strain（GLS）.QFR wascalculated basedoncoronaryangiographyfindings.All patients were followed upfor 12-24 months and divided into the good-prognosis group（ n =87） and the poor-prognosis group（n=17） according to the adverse cardiovascular events.The diferences intheabove parameters between thetwo groups were compared.Multivariate Logistic regression wasused toidentifyindependentinfluencingfactorsforpredictingtheprognosisafterPCIinSTEMIpatients，anda combined model was established.Receiveroperating characteristic（ROC）curve was drawn to analyze thediagnostic performance. ResultsCompared withthe god-prognosis group，theGLSinthe poor-prognosis group wasdecreased，and globalSI，global ESI，andQFR positivityrate were increased，with statisticallysignificant differences（all P <0.05）.MultivariateLogistic regression analysisshowed thatGLS，globalPS，andQFRweretheindependentinfluencingfactorsforpredicting prognosisafterPCIin STEMI patients（all P <0.05）.The combined model equationwas：Logit （P）= -0.075-0.342×GLS+0.214×globalPSI+2.134×QFR. ROC curveanalysisshowedthattheareaunder thecurvethe modelfor predicting prognosis afterPCIin STEMI patients was 0.928（95%CI： 0.871-0.985），with a sensitivity 82.0% and a specificity 89.0% .Conclusion The combined application PSS parameters and QFR has certain clinical value in predicting the prognosis after PCI in STEMI patients.

KEYWORDsSpeckletracking echocardiography，two-dimensional；Acute myocardial infarction；Postsystolic shortening;Quantitative flowratio;Percutaneous coronary intervention;Progosis

经皮冠状动脉介人治疗（percutaneous coronaryintervention，PCI）是ST段抬高型心肌梗死（ST-segmentelevationmyocardialinfarction，STEMI）患者的关键治疗方式，其可通过重建血运有效改善心肌缺血。（剩余10261字）