Page 45 - 南京医科大学自然版

第44卷第4期 南京医科大学学报（自然科学版）
2024年4月 Journal of Nanjing Medical University（Natural Sciences） ·483 ·

·临床研究·

三维斑点追踪技术评价心肌梗死患者心肌微循环特征及对左

心室重塑的预测价值

高 源 ，孙 佳 ，郑 苗 ，吴彦冰 2
1*
2
1
郑州大学附属胸科医院（河南省胸科医院）超声科，南院区超声科，河南 郑州 450000
1 2

［摘 要］ 目的：探讨三维斑点追踪技术评价心肌梗死患者心肌微循环特征及对左心室重塑的预测价值。方法：将 2020 年
8 月—2023年8月于郑州大学附属胸科医院收治的165例心肌梗死患者作为研究对象，根据左心室舒张末期容积指数增加率
（Δleft ventricular end⁃diastolic volume index，ΔLVEDVI）将患者分为左心室重塑组（ΔLVEDVI > 20%，74 例）和无左心室重塑
组（ΔLVEDVI≤20%，91 例）。通过受试者工作特征（receiver operating characteristic，ROC）曲线评价心肌梗死患者心肌微循环
特征对左心室重塑的预测价值。通过逐步回归法筛选心肌梗死患者左心室重塑的影响因素。建立心肌梗死患者左心室重
塑的风险预测模型并进行验证。结果：冠脉介入时间、心梗面积、C 反应蛋白（C⁃reactive protein，CRP）、金属蛋白酶 9（matrix
metalloproteinase⁃9，MMP⁃9）、血管内皮生长因子 A（vascular endothelial growth factor⁃A，VEGF⁃A）、冠状动脉微循环阻力指数
（index of microcirculatory resistance，IMR）、血流储备分数（fractional flow reserve，FFR）和冠状动脉血流储备（coronary flow reserve，
CFR）均为影响心肌梗死患者左心室重塑的独立危险因素（P < 0.05）。校准曲线结果均显示多因素Logistic回归模型具有较好
的准确性。结论：心肌梗死患者心肌微循环特征对左心室重塑具有一定预测价值。
［关键词］ 三维斑点追踪技术；心肌梗死；心肌微循环；左心室重塑
［中图分类号］ R540.45 ［文献标志码］ A ［文章编号］ 1007⁃4368（2024）04⁃483⁃08
doi：10.7655/NYDXBNSN230853

Evaluation of myocardial microcirculation characteristics and predictive value of left
ventricular remodeling in patients with myocardial infarction using three ⁃ dimensional

speckle tracking imaging
2
1
1*
GAO Yuan ，SUN Jia ，ZHENG Miao ，WU Yanbing 2
2
1 Department of Ultrasound，Department of Ultrasound（South Branch），Chest Hospital Affiliated to Zhengzhou
University（Henan Chest Hospital），Zhengzhou 450000，China
［Abstract］ Objective：To explore the evaluation of myocardial microcirculation characteristics and predictive value for left
ventricular remodeling in patients with myocardial infarction using three⁃dimensional speckle tracking imaging. Methods：A total of
165 patients with myocardial infarction admitted to Chest Hospital affiliated to Zhengzhou University from August 2020 to August 2023
were selected for the study. According to the increase rate of left ventricular end⁃diastolic volume index（ΔLVEDVI），the patients were
divided into left ventricular remodeling group（ΔLVEDVI>20%，74 cases）and non⁃left ventricular remodeling group（ΔLVEDVI≤20%，
91 cases）. The predictive value of myocardial microcirculation characteristics for left ventricular remodeling in patients with myocardial
infarction was evaluated using receiver operating characteristic（ROC）curve. The influencing factors of left ventricular remodeling in
patients with myocardial infarction were screened by stepwise regression analysis. A risk prediction model for left ventricular
remodeling in patients with myocardial infarction was established and validated. Results：Coronary intervention time，myocardial
infarction area，C⁃reactive protein（CRP），matrix metalloproteinase⁃9（MMP⁃9），vascular endothelial growth factor⁃A（VEGF⁃A），index of
microcirculatory resistance（IMR），fractional flow reserve（FFR），and coronary flow reserve（CFR）were all independent risk factors
affecting left ventricular remodeling in patients with myocardial infarction（P < 0.05）. The calibration curve results showed that the

［基金项目］ 河南省医学科技攻关计划（2018020565）
∗
通信作者（Corresponding author），E⁃mail：G_aoyuan1354@163.com