摘要
目的利用组织多普勒技术(TDI)评价肺动脉高压(PH)患者右心功能的变化。方法 PH组150例,根据PH程度分为轻度组、中度组、重度组3个亚组(各50例),应用TDI测算三尖瓣3个瓣环处及右室侧壁中部室壁运动速度指标包括等容收缩波正向峰值速度(IVC)、收缩期s波峰值速度(s')、舒张早期e波峰值速度(e')、舒张晚期a波峰值速度(a')以及s、e、a波速度-时间积分(VTIs、VTIe、VTIa);获得三尖瓣血流舒张早期最大流速(E)、舒张晚期最大流速(A)并与正常对照组进行对比分析。结果正常对照组和PH组不同取样点间比较:三尖瓣3个瓣环处的TDI速度指标均表现为前瓣高于后瓣、后瓣高于隔瓣(P<0.001);前瓣IVC、s'、VTIs高于右室侧壁中部同一指标(P<0.05)。与正常对照组相同位点比较,PH组前瓣a'、VTIa升高,VTIe、e'/a'下降,三尖瓣血流E/A下降(P<0.05),IVC、s'、VTIs、e'差异无统计学意义(P>0.05)。与正常对照组相比,IVC、s'和VTIs在轻度组升高、重度组降低,e'在重度组降低,VTIe在中度组和重度组降低,a'、VTIa在轻度组和中度组升高,轻度组、中度组、重度组e'/a'、E/A均下降(P<0.05)。PH组前瓣e'/a'与E/A相关性良好(r=0.382,P<0.001)。e'/a'<1的发生率(42.9%)高于E/A<1的发生率(15.2%)(χ2=21.55,P<0.001)。结论 PH导致右室收缩和舒张功能降低,轻度PH即开始出现舒张功能降低,重度PH收缩功能降低。三尖瓣前瓣TDI速度指标能敏感、准确地反映PH患者右心功能的变化。
Objective To evaluate the change of right ventricular function in patients with pulmonary hypertension （PH） using tissue Doppler imaging（TDI）. Methods 150 patients dignosised with PH were divided into three groups according to the level of PH. Pulsed wave TDI（PW-TDI） velocity parameters including isovolumetric contraction veloci- ty （IVC）, systolic peak velocity （s＇）, early diastolic peak velocity（ e＇）, late diastolic peak velocity（ a＇）, velocity-time integral of s, e and a（ VTIs, VTIe ,VTIa）were measured. Under the apical four-chamber view, the peak of early dias- tolic velocity （E）and late diastolic velocity （A） of the tricuspid flow spectrum that detected by pulsed wave Doppler were measured. Meanwhile, the parameters above were compared with those of the controls. Results All velocity par- aments of anterior tricuspid annular were extremely higher than those of posterior tricuspid annular, and these paraments of posterior tricuspid annular were significant higher than those of septal tricuspid annular in the control group and the PH group （P 〈0. 001 ）. IVC, s＇, VTIs of anterior tricuspid annular were higher than those of middle segment of right ventricular free wall in the control group and the PH group（ P 〈 0.05 ）. Compared with those of tricuspid anterior value in the control group, VTIe, e＇/a＇, E/A were found to be lower and a＇, VTIa to be higher in the patients with PH （ P 〈 0.05）. There was no significant difference in IVC, s＇, VTIs and e, between the two groups. Compared with those of the controls,IVC, s＇ and VTIs increased in the patients with mild PH and decreased in the patients with severe PH. e, decreased in the severe PH group. Moderate and severe PH showed decreasing VTIe. a＇ and VTIa were elevated in the mild and moderate PH groups. Ratio of e＇/a＇ and E/A decrased in the mild,moderate and severe PH groups than that in the controls（ P 〈 0.05 ）. Correlations were found between the e＇/a＇, of tricuspid anteri
出处
《山东大学学报（医学版）》
CAS
北大核心
2013年第4期37-41,共5页
Journal of Shandong University:Health Sciences
基金
山东省交通厅科技项目(2006Y024)
关键词
组织多普勒成像
超声心动描记术
肺动脉高压
右心室功能
Tissue Doppler imaging
Echocardiography
Pulmonary hypertension
Right Ventricular function
