单心动周期实时三维超声心动图对肺高压患者右心功能的研究  

Assess the Right Ventricular Function in Pulmonary Hypertension Patients by Single Cardiac Cycle Real-time Three Dimensional Echocardiography

作　　者：白洋[1] 杨军[1] 王玥[1] 赵斓婷[1] 郭洁[1] 

机构地区：[1]中国医科大学附属第一医院心功能科,沈阳110001

出　　处：《中国医科大学学报》2012年第3期244-246,257,共4页Journal of China Medical University

基　　金：辽宁省自然科学基金资助项目(20092134);高等学校博士学科点专项科研基金资助项目(20112104110010)

摘　　要：目的应用单心动周期实时三维超声心动图(sRT-3DE)评估肺高压患者的右心功能,研究肺高压患者右心功能及影响因素。方法选取我院住院临床诊断为肺高压、经超声心动图评估肺动脉收缩压(sPAP)≥40 mmHg,排除存在左心疾病及先天性体肺分流的25例患者为病例组,正常体检人群25例作为对照组,行常规二维超声心动图及sRT-3DE检查,脱机工作站分析,获得右心相关二维及三维参数。结果对照组右心室舒张末容积(RVEDV)>左心室舒张末容积(LVEDV)(P<0.05),右心室射血分数(RVEF)<左心室射血分数(LVEF)(P<0.05);左、右心室射血量(SV)比较无统计学差异(P>0.05);病例组RVEDV、RVESV与对照组比较增大,RVEF与对照组比较减小,差异均有统计学意义(P<0.01),而RVSV与对照组比较无统计学差异(P>0.05);病例组三维测得的RVEF与面积变化分数(FAC)、三尖瓣环位移(TAPSE)相关(r1=0.887,r2=0.664,P<0.01),RVEDV与sPAP呈正相关(r=0.435,P<0.05),RVEF与sPAP、RVEDV、RVESV呈负相关,与RVSV呈正相关(r1=-0.721,r2=-0.692,r3=-0.866,P<0.01;r4=0.481,P<0.05)。结论 sRT-3DE可以评估正常人及肺高压患者的右心容积和功能,肺高压患者右心室容积增大,射血分数减低,其变化与肺高压程度相关。Objective To assess the right ventricular function of pulmonary hypertension patients by sRT-3DE,and study the influence factors of right ventricular function.Methods A total of 25 inpatients with clinical diagnosis of pulmonary hypertension and sPAP≥40 mmHg estimated by echocardiography were included as case group,presence of left heart disease and congenital Systemic-pulmonary circulation shunt were excluded.A total of 25 healthy people were selected as control group.Conventional 2D-Echocardiography and sRT-3DE were performed in both groups and the offline workstation was used to obtain the right ventricular 2D and 3D parameters.Results In control group,The RVEDV was slightly larger than RVEDV（3.98± 6.93 mL,P 0.05）,RVEF was slightly smaller than LVEF（3.34%± 5.7%,P 0.05）,LVSV had no statistical difference from the RVSV.RVEDV,RVESV increased and RVEF decreased in case group compared with control group（P 0.01）;RVSV had no significant difference with control group.3DRVEF was well correlated with FAC,TAPSE in case group（r 1=0.887,r 2=0.664,P 0.01）.The RVEDV was positively correlated with sPAP（r =0.435,P 0.05）;RVEF was negatively related with sPAP,RVEDV,RVESV and RVSV（r 1=-0.721,r 2=-0.692,r 3=-0.866,P 0.01;r 4=0.481,P 0.05）.Conclusion The right ventricular volume and function can be well evaluated by sRT-3DE in both healthy people and pulmonary hypertension patients.Right ventricular volume increased and ejection fraction decreased in PH patient,which were correlated with the degree of pulmonary hypertension.

关 键 词：肺高压 右心室 实时单心动周期三维超声心动图 

分 类 号：R445.1[医药卫生—影像医学与核医学]