摘要
目的研究右心室功能异常对血压正常肺栓塞患者临床和预后的影响。方法 2001年1月至2004年12月入住本院就诊时血压正常确诊肺栓塞患者,超声心动图检查右室扩张、肺动脉高压作为右室功能异常定量诊断标准。分为血压正常肺栓塞右室功能异常组和正常组,对临床情况进行回顾性分析。结果 57例血压正常肺栓塞患者其中27例右室功能异常,30例右室功能正常。右室功能异常组与正常组肺栓塞相关病死率为19%比0%,差异有统计学意义。结论右室功能异常是增加肺栓塞病死率的一个重要因素。超声心动图能较好地评价右室功能状况,可识别出具有高度死亡危险性的人群。
Objective To investigate the prevalence and clinical outcome of right ventricular （RV） dysfunction among normotensive PE patients. Methods Inclusion criteria included： （ 1 ） Confirmed PE at Sir Run Run Shaw Hospital from January 2001 to December 2004. （2） Normotensive. （3） Echocardiography done before therapy. RV dysfunction was assessed with echocardiography in the presence of one or more of the following criteria： RV dilatation, pulmonary hypertension as evidenced by pulmonary artery systolic pressure 〉30 mm Hg, pulmonary artery mean pressure 〉20 mm Hg and tricuspid regurgitant velocity 〉 2. 8 m/s. The clinical outcome of these two groups normotensive PE patients with and without RV dysfunction was analyzed. Results 57 cases of normotensive PE were included in this study. 27 of the 57 patients were judged to have RV dysfunction. There was no difference in age, gender, prevalence of deep venous thrombosis （DVT）, cancer or other risk factors in these two groups. In the group with RV dysfunction, 5 patients （ 19% ） died as a result of PE. In comparison, in the group without RV dysfunction, only one patient died related to bladder cancer with multiple brain metastasis, so none of the patients of this group died directly related to PE. After therapy, 22 patients of this group became better and RV function also improved in short-term. Conclusions The mortality related to PE in normotensive patients with RV dysfunction is significantly higher than those without. In patients with PE, echocardiography is quite useful because it can often help to detect RV dysfunction which is a significantly high risk of death. After therapy, RV function of normotensive patients with PE will improve in short-term. Echocardiography is an important means of evaluating of therapeutic outcome in pulmonary embolism.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2007年第2期111-113,共3页
Chinese Journal of Internal Medicine
