超声心动图在评价急慢性肺栓塞患者右心功能中的临床意义

doi:10.3969/j.issn.1006-6233.2020.06.034

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摘要目的:研究超声心动图在评价急慢性肺栓塞(PE)患者右心功能中的临床意义。方法:选取2017年10月至2019年10月我院PE患者96例进行研究,其中急性肺栓塞(APE)患者52例,慢性肺栓塞(CPE)患者44例,另选取我院同期健康体检者50例为对照组,采用二维超声心动图(2DE)测量右心室前壁厚度(RVAWTd)、右心室横径(RV)、右心房横径(RA)、肺动脉主干内径(MPA)、右心室舒张末期容积(RVEDV)、收缩末期容积(RVESV)、每搏输出量(RVSV)并计算右室射血分数(RVEF),采用组织多普勒成像(TDI)技术检测并测量右室Tei指数等参数,进行比较和分析。结果:APE组RVAWTd、RV及RA高于对照组,差异无统计学意义(P>0.05),CPE组RVAWTd、RV及RA高于APE组和对照组,差异有统计学意义(P<0.05);APE组RVEDV、RVESV及PASP均高于对照组,RVSV和RVEF低于对照组,且CPE组RVEDV、RVESV及PASP高于APE组和对照,RVSV和RVEF低于APE组和对照,差异均有统计学意义(P<0.05);APE组ICT+IRT、ET及右室Tei指数高于对照组,且CPE组ICT+IRT、ET及右室Tei指数高于APE组和对照,差异有统计学意义(P<0.05)。结论:2DE和TDI技术可准确反映APE及CPE患者右心室舒缩功能,为临床诊断和急慢性鉴别提供重要参考信息。

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关键词 ：肺栓塞, 右心室功能, 超声心动图, Tei指数

Abstract：Objective: To study the clinical significance of ultrasonic cardiogram in evaluating right heart function in patients with acute or chronic pulmonary embolism (PE). Methods: 96 patients with PE in our hospital from October 2017 to October 2019 were selected for the study. Among them were 52 cases of acute pulmonary embolism (APE) and 44 cases of chronic pulmonary embolism (CPE). Another 50 cases of healthy examiners in our hospital at the same period were selected as control group. The two-dimensional ultrasound, tissue Doppler imaging (TDI) were performed, and the right ventricular anterior wall thickness (RVAWTd), right ventricular transverse diameter (RV), right atrial transverse diameter (RA), main pulmonary artery diameter (MPA), right ventricular end-diastolic volume (RVEDV), end-systolic volume (RVESV), stroke volume (RVSV), right ventricular ejection fraction (RVEF), and right ventricular Tei index were compared and analyzed. Results: The RVAWTd, RV and RA in APE group were significantly higher than those in control group (P>0.05). The RVAWTd, RV and RA in CPE group were higher than those in APE group and control group (P<0.05). The RVEDV, RVESV and PASP in APE group were higher than those in control group, and the RVSV and RVEF were lower than those in control group, and the RVEDV, RVESV and PASP in CPE group were higher than those in APE group and control group, and the RVSV and RVEF were lower than those in APE group and control group (P<0.05). The ICT+IRT, ET and right ventricular Tei index in APE group were higher than those in control group, and the ICT+IRT, ET and right ventricular Tei index in CPE group were higher than those in APE group and control group (P<0.05). Conclusion: TDI and 2DE can accurately reflect the right ventricular systolic and diastolic function in patients with APE and CPE. Ultrasonic cardiogram evaluation of right heart function in PE patients can provide important reference information for clinical diagnosis and acute and chronic identification.

Key words： Pulmonary embolism Right ventricular function Ultrasonic cardiogram Tei index

基金资助:河北省承德市科学技术研究与发展计划项目,(编号:201701A070)

引用本文:

秦诗阳, 曹雪松, 房亮, 张蕊, 刘会玲. 超声心动图在评价急慢性肺栓塞患者右心功能中的临床意义[J]. 河北医学, 2020, 26(6): 1032-1035.
QIN Shiyang, CAO Xuesong, FANG Liang, et al. An Analysis of the Clinical Significance of Ultrasonic Cardiogram in Evaluating Right Heart Function in Patients with Acute or Chronic Pulmonary Embolism. HeBei Med, 2020, 26(6): 1032-1035.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2020.06.034 或 http://www.hbyxzzs.cn/CN/Y2020/V26/I6/1032

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