摘要
目的应用实时三维超声心动图（RT-3DE）和超声二维斑点追踪（STI）技术评价原发性肺动脉高压（PPH）患者右心室（RV）收缩功能。方法根据肺收缩压选择确诊PPH患者轻、中、重度三组各20例，抽取健康成年人志愿者20例作为对照组。应用RT-3DE和STI技术分别观察右心室整体功能[舒张末期容积（EDV）、收缩末期容积（ESV）、每博输出量（SV）和射血分数（EF）指数]以及三尖瓣环收缩期位移（TAPSE）、右心室游离壁、室间壁基底段、中间段和心尖段纵向收缩峰值位移速度（VL）和收缩期蜂值应变（sL）及应变率（SRL）。结果轻、中、重度组右心室ESV均明显大于对照组（t=3．10、7．53、7．72，均P〈0．01），中、重度组右心室EDV均明显大于对照组和轻度组（t=4．02、5．82、3．04、5．15，均P〈0．01），SV和EF小于对照组（t=-9．33～-2．71，均P〈0．05），各组间EF差异均有统计学意义（t=-4．21～-14．76，均P〈0．01），且右心室ESV、右心室EDV与EF呈负相关（r=-0．776、-0．638，均P〈0．01）；PPH各组计算TAPSE游离壁三尖瓣环处、室间隔瓣环处、三尖瓣环连线中点处值和右心室纵向缩短率均明显小于对照组（均P〈0．01），且与EF值呈正相关（r=0．761、0．593、0．745、0．773，均P〈0．01）；PPH各组右心室游离壁和室间壁基底段、中间段和心尖段VL和SL测值小于对照组（P〈0．05或P〈0．01），而各组间SRL值差异无统计学意义（P〉0．05）。结论RT-3DE和STI技术等超声新技术可有效地定量评诂PPH患者各时段右心功能情况。
Objective To evaluate the right ventricular （RV） systolic function in patients with primary pulmonary hypertension（PPH） using real - time three - dimensional echocardiography（ RT - 3DE） and ultrasonic two - dimensional speckle tracking imaging（STI）. Methods Patients with PPH were divided into three groups according to pulmonary arterial systolic pressure（PASP） ,consisted of mild group, moderate group and severe group,with 20 cases in each group. 20 healthy cases were included as the control group. The global RV dysfunction, including RV end - diastolic volume （ EDV）, end - systolic volume （ ESV ）, stroke volume （ SV ）, ejection fraction （ EF ）, tricuspid annular plane systolic excursion （ TAPSE）, longitudinal peak systolic strain （ SL）, longitudinal peak systolic strain rate （ SRL）, longitudinal peak systolic velocity（VL） in RV free wall and interventricular septum for basal,mid and apical segment were detected by using RT - 3DE and STI. Results Global RV ESV increased in all groups（ t = 3.10,7.53,7, 72, all P 〈 0.01 ）, but The RV EDV in the moderate and severe group was higher than that of normal and mild groups （t = 4. 02,5.82,3.04,5.15, all P 〈 0.01 ）, the RT SV and EF in all case groups was fewer than that of normal （ t = - 9.33 - - 2.71, all P 〈 0.05）. Linear correlation analysis showed negative correlation between EF and ESV, EDV （ r = - 0. 776, - 0. 638, all P 〈 0.01 ）. The level of RV free wall peak systolic displacement of tricuspid annulus, ventricular septal annulus peak systolic displacement, tricuspid annulus peak systolic displacement midpoint and the right longitudinal ventricular shortening fraction were significantly lower than those of the control group（ all P 〈 0.01 ）.Linear correlation analysis showed positive correlation between EF and TAPSE （ r = 0. 761,0. 593,0. 745,0. 773, all P 〈 0.01 ）. The VL and SL in RV free wall and interventricular septum for basal, mid and apical segment were fewer than the cont
出处
《中国基层医药》
CAS
2016年第1期42-47,I0003,共7页
Chinese Journal of Primary Medicine and Pharmacy
基金
浙江省瑞安市科技创新基金项目（YY2014054）
关键词
超声心动描记术
三维
高血压
肺性
心室功能
右
Echocardiography
Three - dimensional
Hypertension
Pulmonary
Ventricular function
Right
