肺部超声诊断急性前壁心肌梗死合并肺水肿的价值

张丹丹; 苏兴; 王青雷; 左汉恒; 崔英华

doi:10.13201/j.issn.1001-1439.2020.01.007

肺部超声诊断急性前壁心肌梗死合并肺水肿的价值

- 济宁医学院附属医院心血管内科(山东济宁, 272000)
基金项目:
济宁医学院附属医院“苗圃”课题(No:MP-2016-MS-017)

详细信息

通讯作者: 崔英华,E-mail:jyfycyh@163.com

中图分类号: R542.2

收稿日期: 2019-10-16

The value of pulmonary ultrasound in the diagnosis of acute anterior wall myocardial infarction complicated with pulmonary edema

- Department of Cardiology, Affiliated Hospital of Jining Medical College, Jining, Shandong, 272000, China

More Information

Corresponding author: CUI Yinghua, E-mail: jyfycyh@163.com

Received Date: 16 October 2019

摘要

摘要: 目的:探讨肺部超声在急性前壁心肌梗死患者中诊断肺水肿的价值。方法:随机纳入2017-01-2017-12住院的急性前壁心肌梗死患者68例,所有患者入院当日均接受心脏超声、肺部超声、下腔静脉超声及胸片、脑钠肽(BNP)检查,以临床确诊为金标准,比较分析肺部超声与胸片诊断肺水肿的灵敏度、特异度、阳性预测值、阴性预测值及准确度的差异,计算两者诊断肺水肿的Kappa值。同时对肺部B线数目与BNP、E/e'、左室射血分数(LVEF)、下腔静脉塌陷率、Tei指数、左室等容舒张时间(IVRT)、E波减速时间(EDT)进行相关分析。结果:①肺部超声较胸片诊断心源性肺水肿诊断灵敏度、特异度及准确度更高,差异有统计学意义(P<0.01),一致率为64.7%,Kappa值=0.294;②肺部B线数目与BNP、E/e'呈正相关,与LVEF、下腔静脉塌陷率呈负相关,与Tei指数、IVRT、EDT无明显相关性。结论:肺部超声在诊断急性前壁心肌梗死合并肺水肿方面灵敏度、特异度以及准确度更高,肺水肿程度与患者心脏收缩和舒张功能具有良好的相关性。
- 肺部超声 /
- 急性前壁心肌梗死 /
- 肺水肿 /
- B线
Abstract: Objective:To investigate the value of pulmonary ultrasound in the diagnosis of pulmonary edema in patients with acute anterior myocardial infarction.Method:A total of 68 patients with acute anterior myocardial infarction admitted to our hospital from January 2017 to December 2017 were enrolled.All patients underwent echocardiography,pulmonary ultrasound,inferior vena cava ultrasound and chest radiography on the day of admission.We analyzed the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of pulmonary ultrasound and chest X-ray in the diagnosis of pulmonary edema,and calculated the Kappa value of the diagnosis of pulmonary edema.At the same time,the number of B-line in the lung and B-type natriuretic peptide(BNP),E/e',left ventricular ejection fraction(LVEF),inferior vena cava collapse rate,Tei The index,left ventricular isovolumic relaxation time(IVRT),E wave deceleration time(EDT) were correlated.Result:①The sensitivity,specificity and accuracy of pulmonary ultrasound in the diagnosis of cardiogenic pulmonary edema were higher.The difference was significant statistically(P＜0.01).The agreement rate was 64.7%,and Kappa value=0.294;②The number of B-line in the lung was positively correlated with BNP and E/e',and negatively correlated with left ventricular ejection fraction and inferior vena cava collapse rate.There was no significant correlation with Tei index,IVRT and EDT.Conclusion:Pulmonary ultrasound is more sensitive,specific and accurate in the diagnosis of acute anterior myocardial infarction complicated with pulmonary edema.The degree of pulmonary edema has a good correlation with the systolic and diastolic function of heart.
- lung ultrasound /
- acute anterior myocardiac infarction /
- pulmonary edema /
- B-line

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