超声心动图评价系统性硬化病肺动脉高压的临床研究  

Evaluation of pulmonary artery hypertension in patients with systemic sclerosis by echocardiography

作　　者：李媛[1] 张军辉[1] 曹礼庭[1] 顾鹏[1] 魏锦[2] 罗文峰[2] 张青[1] 张敏惠[1] 蒋冰蕾[1] 

机构地区：[1]川北医学院附属医院超声诊断科,四川南充637000 [2]川北医学院附属医院风湿血液科,四川南充637000

出　　处：《中华医学超声杂志（电子版）》2011年第10期2135-2140,共6页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨超声心动图评价系统性硬化病(SSc)患者肺动脉高压的临床价值。方法连续选择23例SSc患者及29名年龄和性别匹配的健康志愿者。常规二维超声测量各房室内径,主肺动脉内径(MPA);多普勒超声测定肺动脉前向血流速度(Vpa)、右心室射血前期(RPEP)、右心室射血期(RVET)、肺动脉血流加速时间(AcT),并计算其比值:AcT/RVET、AcT/RPEP、RPEP/RVET;利用三尖瓣反流压差估测肺动脉收缩压。结果 SSc患者右心房上下径(RAd)、左右心室内径比值(LVdd/RVdd)分别为(41.74±5.19)mm、(2.04±0.27),对照组分别为(36.89±3.22)mm、(2.18±0.15),两组比较差异有统计学意义(t=4.122、-2.312,P=0.000、0.025)。SSc患者MPA为(22.23±3.04)mm,对照组为(19.34±1.70)mm,两组比较差异有统计学意义(t=4.308,P=0.000)。SSc患者Vpa、AcT分别为(0.88±0.17)m/s、(118.26±30.87)ms,对照组分别为(0.85±0.15)m/s、(145.44±6.28)ms,两组比较差异有统计学意义(t=0.851、-3.365,P=0.393、0.002)。SSc患者RVET、RPEP分别为(330.78±54.31)ms、(96.26±26.11)ms,对照组的分别为(340.10±27.05)ms、(87.52±20.44)ms,两组比较差异无统计学意义(t=-0.808、1.317,P=0.423、0.195)。SSc患者AcT/RVET、AcT/PREP、RPEP/RVET比值分别为(0.37±0.11)、(1.29±0.43)、(0.31±0.74),对照组的分别为(0.43±0.70)、(1.74±0.47)、(0.26±0.69),差异有统计学意义(t=-2.466、-3.611、2.678,P=0.017、0.001、0.000)。SSc组8例(34.8%,8/23)发生肺动脉高压(PAH)。结论超声心动图可作为评价SSc患者肺动脉压力的重要方法。Objective To evaluate the clinical valve of pulmonary artery hypertension(PAH)in patients with systemic sclerosis(SSc)by echocardiography.Methods This study included 29 healthy participants as the control group and 23 patients with systemic sclerosis.All of them were examined by echocardiography.Right atrial diameter(RAd),left ventricular diastolic diameter(LVdd),right ventricular diastolic diameter(RVdd)and main pulmonary artery diameter(MPA)were measured.Pulmonary valve flow velocity(Vpa),right ventricular preejection period(RPEP),right ventricular ejection period(RVET)and acceleration time(AcT)were measured by pulse wave Doppler(PWD),AcT/RVET、AcT/RPEP、RPEP/RVET was measured.Tricuspid regurgitation velocity(TRVmax)and pressure gradient(PG)were measured to estimate pulmonany arterial systotic pressure(PASP).Results RAd was(41.74±5.19)mm in SSc group,and(36.89±3.22)mm in the control group,there were significant differences between the two groups(t=4.122,P=0.000).LVdd/RVdd was(2.04±0.27)in SSc group,and(2.18±0.15)in the control group,there were significant differences between the two groups(t=-2.312,P=0.025).MPA was(22.23±3.04)mm in SSc group,and(19.34±1.70)mm in the control group,there were significant differences between the two groups(t=4.308,P=0.000).Vpa was(0.85±0.15)m/s in SSc group,and(0.88±0.17)m/s in the control group,there were no significant difference between the two groups(t=0.851,P=0.393).AcT was(118.26±30.87)ms in SSc group,and(145.44±6.28)ms in the control group,there were significant differences between the two groups(t=-3.365,P=0.002).RVET and RPEP in SSc group were(330.78±54.31)and(96.26±26.11)ms,and in the control group were(340.10±27.05) and(87.52±20.44)ms,espectively.There were no significant difference between the two groups(t=-0.808,1.317,P=0.423,0.195).AcT/RVET,AcT/PREP and RPEP/RVET ratio in SSc group were(0.37±0.11),(1.29±0.43) and(0.31±0.74),and in the control group were(0.43±0.70),(1.74±0.47)and(0.26±0.69).There were significant differences between the two group

关 键 词：超声心动描记术 系统性硬化病 肺动脉高压 

分 类 号：R445.1[医药卫生—影像医学与核医学]