第一阶段射血分数联合LVEF和GLS诊断肝硬化心肌病价值研究

doi:10.3969/j.issn.1672-5069.2026.03.014

摘要/Abstract

摘要： 目的评估第一阶段射血分数(EF1)联合左心室射血分数(LVEF)和左心室整体纵向应变(GLS)诊断肝硬化并发心肌病(CCM)的价值。方法 2024年7月～2025年6月大连医科大学第二附属医院就诊的肝硬化患者127例和健康人40例,行心脏常规超声检测LVEF、GLS和EF1,应用受试者工作特征(ROC)曲线分析三者联合诊断CCM的效能。结果本组诊断CCM者44例(34.6%);CCM组LVEF、GLS和EF1分别为(55.3±4.6)%、(17.4±2.0)%和(24.2±3.4)%,均显著低于肝硬化组【分别为(62.1±4.1)%、(21.7±2.2)%和(32.1±3.4)%,P<0.05】或健康人组【分别为(60.9±3.5)%、(20.7±1.9)%和(30.5±2.5)%,P<0.05】;EF1联合LVEF和GLS诊断肝硬化患者并发CCM的AUC为0.969,诊断效能显著优于单项指标诊断。结论 EF1能敏感地反映肝硬化并发心肌病患者左心室收缩功能状态,EF1联合LVEF和GLS有助于提高肝硬化患者心肌病的早期检出率。

关键词: 肝硬化, 心肌病, 第一阶段射血分数, 左心室射血分数, 整体纵向应变, 左心室收缩功能, 诊断

Abstract: Objective The purpose of this study was to investigate diagnostic performance of first-phase ejection fraction (EF1) in combination with left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) in predicting cirrhotic cardiomyopathy (CCM). Methods 127 patients with liver cirrhosis (LC) and 40 healthy individuals for physical examination were encountered in our hospital between July 2024 and June 2025, and all underwent conventional echocardiography for EF1, LVEF and GLS. Receiver operating characteristic (ROC) curve was applied to evaluate diagnostic efficacy. Results CCM was found in 44 cases (34.6%) in our series; LVEF, GLS and EF1 in CCM group were (55.3±4.6)%, (17.4±2.0)% and (24.2±3.4)%, all significantly lower than [(62.1±4.1)%, (21.7±2.2)% and (32.1±3.4)%, respectively, P<0.05] in patients with LC or [(60.9±3.5)%, (20.7±1.9)% and (30.5±2.5)%, respectively, P<0.05] in healthy control; AUC was 0.969, when EF1 in combination with LVEF and GLS was applied to predict CCM in patients with LC, much superior to any parameter did alone. Conclusion EF1 sensitively reflects alterations of left ventricular systolic functions in patients with CCM, and the combination of EF1, LVEF and GLS could help clinicians early screen CCM.

Key words: Liver cirrhosis, Cirrhotic cardiomyopathy, First-phase ejection fraction, Left ventricular ejection fraction, Global longitudinal strain, Left ventricular systolic function, Diagnosis

杨茜, 杨冰冰, 王许, 蒋国宁, 聂婧怡, 杨婧妍, 礼广森. 第一阶段射血分数联合LVEF和GLS诊断肝硬化心肌病价值研究[J]. 实用肝脏病杂志, 2026, 29(3): 373-376.

Yang Xi, Yang Bingbing, Wang Xu, et al. Diagnostic performance of first-phase ejection fraction in combination with LVEF and GLS in predicting cirrhotic cardiomyopathy[J]. Journal of Practical Hepatology, 2026, 29(3): 373-376.

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