收缩期偏心指数评价肺高压对右心室收缩功能的影响  

Systolic eccentricity index identifies right ventricular systolic dysfunction in patients with pulmonary hypertension

作　　者：赵斓婷[1] 杨军[1] 马春燕[1] 白洋[1] 刘爽[1] 

机构地区：[1]中国医科大学附属第一医院心血管超声科,沈阳110001

出　　处：《中华临床医师杂志（电子版）》2012年第24期7995-7997,共3页Chinese Journal of Clinicians(Electronic Edition)

基　　金：高等学校博士学科点专项科研基金联合资助项目(20112104110010)

摘　　要：目的应用收缩期偏心指数(SEI)评价肺高压(PH)对右心室收缩功能的影响。方法测量45例PH患者(PH组)及20例健康受检者(Con组)左心室短轴二尖瓣(base)、乳头肌(mid)及心尖(api)水平切面SEI,并测量右心室面积变化率(RVFAC)。同时将PH组分为轻、中、重度组,比较各组间差异。结果随着肺动脉收缩压(PASP)的升高,SEI和RVFAC减低(P<0.05)。与Con组比较,轻度组SEIbase、SEImid减低(P<0.05);中度组SEIbase、SEImid和RVFAC减低(P<0.05);重度组三水平SEI和RVFAC均显著减低(P<0.01)。SEIbase与PASP、RVFAC相关性良好(r1=-0.672,r2=0.623,P均<0.001)。SEI-base预测轻、中、重度PH的敏感度和特异度分别为88%、75%,79%、71%及88%、78%。结论 PH患者SEI减低且与PH程度相关;SEIbase能预测不同程度PH致右心室收缩功能障碍的程度,并为临床鉴别PH程度提供一个新途径。Objective To evaluate the right ventricular systolic function in patients with pulmonary hypertension by systolic eccentricity index(SEI).Methods Right ventricular fractional area change(RVFAC)was traditionally measured in 45 patients with pulmonary hypertension(PH group)and 20 age-matched controls(Con group).SEI has been calculated at the short axis view of mitral valve(SEIbase),papillary muscle(SEImid)and apical(SEIapi)level.Results SEI and RVFAC reduced during the upgrade of PASP(P<0.05).Compared with the Con group,SEIbase and SEImid decreased in the mild group(P<0.05);SEIbase,SEImid and RVFAC decreased in the moderate group(P<0.05);SEI of all three levels and RVFAC significantly decreased(P<0.01)in the severe group.SEIbase was strongly correlated with PASP and RVFAC(r1=-0.672,r2=0.623,both P<0.001).Sensitivity and specificity of SEIbase in indentifying the mild,moderate and severe PH was 88% and 75%,79% and 71%,88% and 78%,respectively.Conclusions The reduction of SEI in patients with PH is correlated with the degree of PH.SEIbase can reflect the right ventricular systolic dysfunction with different levels of PH.SEIbase also provides a new approach of distinguish the degree of PH for clinical applications.

关 键 词：高血压 肺性 心室功能 右 收缩期偏心指数 

分 类 号：R543.2[医药卫生—心血管疾病]