文章摘要
卢云凤,刘东君,郝艳丽,黄 莺,康佳茹,陶斯阳.心脏磁共振成像诊断原发性醛固酮增多症患者左室重构价值研究[J].,2023,(24):4776-4780
心脏磁共振成像诊断原发性醛固酮增多症患者左室重构价值研究
Study on the Value of Cardiac Magnetic Resonance Imaging in the Diagnosis of Left Ventricular Remodeling in Patients with Primary Aldosteronism
投稿时间:2023-06-06  修订日期:2023-06-30
DOI:10.13241/j.cnki.pmb.2023.24.035
中文关键词: 心脏磁共振成像  原发性醛固酮增多症  原发性高血压  左室重构  诊断价值
英文关键词: Cardiac magnetic resonance imaging  Primary aldosteronism  Primary hypertension  Left ventricle remodeling  Diagnostic value
基金项目:辽宁省教育厅面上项目(LJKMZ20221778)
作者单位E-mail
卢云凤 辽宁省金秋医院心内科 辽宁 沈阳 110016 17740077568@163.com 
刘东君 辽宁省金秋医院影像科 辽宁 沈阳 110016  
郝艳丽 辽宁省金秋医院心内科 辽宁 沈阳 110016  
黄 莺 辽宁省金秋医院心内科 辽宁 沈阳 110016  
康佳茹 沈阳医学院附属第二医院放射科 辽宁 沈阳 110035  
陶斯阳 沈阳医学院附属第二医院心内科 辽宁 沈阳 110035  
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中文摘要:
      摘要 目的:探讨心脏磁共振成像(CMRI)诊断原发性醛固酮增多症(PA)患者左室重构的价值。方法:选取2017年10月-2022年12月在辽宁省金秋医院诊断为PA的患者82例作为研究组,另选取同时期内在我院就诊的原发性高血压(EH)患者82例作为对照组。对比研究组和对照组临床资料、CMRI参数、生化及激素指标水平。根据研究组患者有无左室重构分为PA且有左室重构亚组(PA1组,n=38)和PA但无左室重构亚组(PA2组,n=44),对比PA1组和PA2组患者CMRI参数。采用多因素Logistic回归分析 PA患者左室重构的因素,建立回归方程及ROC曲线评价CMRI对PA患者左室重构的诊断效能。结果:研究组患者血清K、肾素活性低于对照组,醛固酮显著高于对照组(P<0.05)。研究组患者EDVi、ESVi、Massi、初始T1 mapping值和ECV均高于对照组,增强后T1 mapping值低于对照组(P<0.05)。多因素Logistic回归分析结果显示,ESVi、Massi、增强后T1 mapping值、ECV均与PA患者左室重构密切关联(P<0.05)。ROC分析结果显示,ESVi、Massi、增强后T1 mapping值、ECV各指标及其联合诊断PA患者左室重构时的AUC分别为0.623、0.677、0.736、0.675、0.779,说明联合诊断效能较高。结论:CMRI可定量评估PA患者的左室重构情况,其诊断效能较高,可为临床治疗、监测进展等提供参考依据。
英文摘要:
      ABSTRACT Objective: To investigate the value of cardiac magnetic resonance imaging (CMRI) in the diagnosis of left ventricular remodeling in patients with primary aldosteronism (PA). Methods: 82 patients diagnosed as PA in Liaoning Jinqiu Hospital from October 2017 to December 2022 were selected as the study group, another 82 patients with essential hypertension (EH) who visited our hospital in the same period were selected as the control group. The clinical data, the CMRI parameters, biochemical and hormonal indexes between the study group and the control group were compared. Patients in the study group were divided into PA with and without left ventricular remodeling subgroup (PA1 group, n=38) and PA without left ventricular remodeling subgroup (PA2 group, n=44), and the CMRI parameters of patients in PA1 group and PA2 group were compared. Multivariate Logistic regression was used to analyze the factors of left ventricular remodeling in patients with PA, and regression equation and ROC curve were established to evaluate the diagnostic efficacy of CMRI on left ventricular remodeling in patients with PA. Results: Serum K and renin activity in the study group were lower than those in the control group, while aldosterone was significantly higher than that in the control group (P<0.05). The EDVi, ESVi, Massi, initial T1 mapping value and ECV of the study group were higher than those of the control group, and the enhanced T1 mapping value was lower than that of the control group (P<0.05). Multivariate Logistic regression analysis showed that ESVi, Massi, enhanced T1 mapping value and ECV are closely related to left ventricular remodeling in patients with PA (P<0.05). The ROC analysis results showed that the AUC of ESVi, Massi, enhanced T1 mapping value, ECV indicators and their combined regression prediction models in diagnosing left ventricular remodeling in patients with PA were 0.623, 0.677, 0.736, 0.675 and 0.779 respectively, indicated a high diagnostic efficiency of the combined diagnosis. Conclusion: CMRI can quantitatively evaluate the left ventricular remodeling in patients with PA, and its diagnostic efficacy is high;it can provide reference for clinical treatment and monitoring progress.
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