超声二维斑点追踪技术联合血清凝血酶敏感蛋白1检测对老年高血压患者合并心脏病的评估价值

Value of two-dimensional speckle tracking imaging combined with serum thrombospondin-1 in assessing cardiac diseases in elderly hypertensive patients

摘要:

目的 探讨超声二维斑点追踪技术（2D-STI）联合血清凝血酶敏感蛋白1（TSP-1）对老年高血压患者合并心脏病的评估价值。方法 选取2023年10月—2024年10月秦皇岛市中医医院收治的老年高血压患者206例，将121例无其他心血管疾病的患者作为对照组，将85例合并心脏病的患者作为观察组。比较两组患者心功能［左心室舒张末期内径（LVEDD）、左心室射血分数（LVEF）］、左心室舒张末期左心房峰值应变率（SRa）、左心室舒张早期左心房峰值应变率（SRe）、左心室收缩期左心房峰值应变率（SRs）及血清TSP-1水平。通过多因素一般Logistic回归模型分析高血压合并心脏病的影响因素，利用受试者工作特征（ROC）曲线分析2D-STI联合血清TSP-1对老年高血压患者合并心脏病的诊断效能。结果 观察组LVEDD、SRa和TSP-1水平均高于对照组（P <0.05），LVEF、SRe和SRs水平均低于对照组（P <0.05）。多因素一般Logistic回归分析结果显示：SRa水平高［O^R=62.473（95% CI：6.196，629.857）］、TSP-1水平高［O^R=1.504（95% CI：1.270，1.782）］均为高血压患者合并心脏病的危险因素（P <0.05），而SRe水平高［O^R=0.095（95% CI：0.016，0.575）］、SRs水平高［O^R=0.011（95% CI：0.001，0.099）］是独立保护因素（P <0.05）。ROC曲线显示，2D-STI联合TSP-1诊断老年高血压心脏病患者的下曲线下面积为0.986（95% CI：0.975，0.997），敏感性为94.1%（95% CI：0.868，0.981），特异性为93.4%（95% CI：0.874，0.971）。结论 2D-STI联合血清TSP-1对老年高血压心脏病有较高的诊断价值。

Abstract:

Objective To analyze the value of two-dimensional speckle tracking imaging (2D-STI) combined with ?serum thrombospondin-1 (TSP-1) in assessing cardiac diseases in elderly hypertensive patients.Methods A total of 206 elderly hypertensive patients admitted to our hospital from October 2023 to October 2024 were enrolled. Patients without other cardiovascular diseases were assigned to the control group (n = 121), while those with comorbid cardiac diseases were assigned to the observation group (n = 85). The cardiac function [?left ventricular end-diastolic diameter (LVEDD) and ?left ventricular ejection fraction (LVEF)], left atrial peak strain rate at left ventricular end-diastole (SRa), left atrial peak strain rate during early left ventricular diastole (SRe), left atrial peak strain rate during left ventricular systole (SRs), and serum TSP-1 levels were compared between the two groups. Multivariable logistic regression analysis was used to identify influencing factors for cardiac diseases in hypertensive patients, and receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic efficacy of 2D-STI combined with serum TSP-1.Results The observation group exhibited higher LVEDD, SRa, and TSP-1 levels (P < 0.05), but lower LVEF, SRe, and SRs compared to the control group (P < 0.05). The multivariable logistic regression analysis indicated that elevated SRa [O^R = 62.473 (95% CI: 6.196, 629.857) ] and TSP-1 levels [O^R = 1.504 (95% CI: 1.270, 1.782) ] were risk factors for the occurrence of cardiac diseases in elderly hypertensive patients (P < 0.05), and that increased SRe [O^R = 0.095 (95% CI: 0.016, 0.575) ] and SRs [O^R = 0.011 (95% CI: 0.001, 0.099) ] were independent protective factors (P < 0.05). The receiver operating characteristic (ROC) curve analysis demonstrated that the combination of 2D-STI and TSP-1 for diagnosing cardiac diseases in elderly hypertensive patients yielded an area under the curve of 0.986 (95% CI: 0.975, 0.997), with a sensitivity of 94.1% (95% CI: 0.868, 0.981) and a specificity of 93.4% (95% CI: 0.874, 0.971).Conclusion The combination of ?2D-STI and ?serum TSP-1 exhibits high diagnostic value for cardiac diseases in elderly hypertensive patients.