摘要
目的探讨超声测量肝硬化患者右心功能与Child-Pugh分级的相关性。方法选取2021年3月至2023年3月在亳州宝璋医院就诊的78例肝硬化患者和同期78名健康体检者。根据Child-Pugh分级将78例肝硬化患者分为A级(38例)、B级(30例)、C级(10例)3组。比较肝硬化患者与健康人的右心结构及右心功能指标,比较不同分级患者右心功能差异,分析两者的相关性。结果肝硬化组RASd、RALd、RADd、RVDd、RVAW分别为(38.79±4.16)mm、(44.94±5.17)mm、(36.07±2.16)mm、(21.45±1.84)mm、(2.39±0.57)mm,均显著高于对照组(35.42±2.88)mm、(41.01±4.13)mm、(35.31±2.08)mm、(19.38±1.63)mm、(2.01±0.21)mm,差异均有统计学意义(P<0.05)。两组E/E’分别为(6.50±1.39)、(6.60±1.62),差异均有统计学意义(P>0.05);肝硬化组RVFAC、E/A分别为(43.20±6.04)%、(1.28±0.27),低于对照组(45.08±4.12)%、(1.39±0.31);而TAPSE、Tei指数分别为(23.80±3.06)mm、(0.43±0.10),高于对照组(22.61±3.11)mm、(0.37±0.12)(P<0.05)。Child-Pugh分级A级的肝硬化患者RVFAC为(41.71±5.03)%,低于B级患者(45.09±6.07)%;E/A为(1.41±0.36),高于C级患者(1.11±0.21);Tei指数为(0.38±0.09),低于C级患者(0.45±0.04),差异均有统计学意义(P<0.05)。经相关性分析,E/A与Child-Pugh分级呈现负相关,Tei指数与Child-Pugh分级呈现正相关(P<0.05)。结论超声测量肝硬化患者右心功能简便,重复性好,超声检查显示肝硬化患者存在右心功能损伤,且随肝硬化病情进展加重。
Objective To investigate the correlation between right heart function measured by ultrasound and Child-Pugh grading in patients with cirrhosis.Methods A retrospective analysis was conducted on 78 patients with liver cirrhosis as the observation group and 78 healthy individuals who underwent physical examination from March 2021 to March 2023 as the control group.According to Child-Pugh classification,78 patients with cirrhosis were divided into Grade A(N=38 cases),Grade B(N=30 cases)and grade C(N=10 cases)groups.The right ventricular structure and right cardiac function indexes of cirrhosis patients and healthy subjects were compared.The difference of right heart function in patients with different Child-Pugh grades was compared and the correlation between them was analyzed.Results In the observation group,right atrial systolic diameter(RASd),right atrium long diameter(RALd),right atrial diastolic diameter(RADd),right ventricular diastolic diameter(RVDd)and right ventricular wall thickness(RVAW)were(38.79±4.16)mm,(44.94±5.17)mm,(36.07±2.16)mm,(21.45±1.84)mm,and(2.39±0.57)mm,respectively,which were significantly higher than those of(41.01±4.13)mm,(35.31±2.08)mm,(19.38±1.63)mm,(2.01±0.21)mm,and(35.42±2.88)mm in the control group(P<0.05).The early mitral inflow velocity and mitral annular early diastolic velocity(E/E')values of the two groups were(6.50±1.39)and(6.60±1.62),respectively,and there was no significant difference(P>0.05).The right ventricular fractional area change(RVFAC)and early to late diastolic transmitral flow velocity(E/A)of the observation group were(43.20±6.04)%and(1.28±0.27),respectively,which were significantly lower than those of(45.08±4.12)%and(1.39±0.31)in the control group.The tricuspid annular planes systolic excursion(TAPSE)and myocardial performance index(Tei index)of the observation group were(23.80±3.06)mm and(0.43±0.10),respectively,which were significantly higher than those of(22.61±3.11)mm and(0.37±0.12)mm in the control group(P<0.05).The RVFAC of cirrhosis patient
作者
刘苏惠
马雅锋
丁丽莉
LIU Su-hui;MA Ya-feng;DING Li-li(Department of Ultrasound,Bozhou Baozhang Hospital,Anhui 236700,China)
出处
《肝脏》
2024年第2期166-169,共4页
Chinese Hepatology
基金
安徽省卫计委科研计划项目(2016QK050)。
关键词
超声
肝硬化
右心功能
CHILD-PUGH分级
相关性
ultrasound
cirrhosis of the liver
right heart function
Child-Pugh classification
correlation
