超声心动图对先天性心脏病右心室功能的评价  

Echocardiographic estimation of right ventricular function in patients with congenital heart disease

作　　者：崔亚玲[1,2] 黄新胜[2] 黄奕高[2] 黄涛[2] 张曹进[2] 

机构地区：[1]南方医科大学,广州510515 [2]广东省医学科学院广东省人民医院广东省心血管病研究所,广州510080

出　　处：《岭南心血管病杂志》2012年第4期375-379,402,共6页South China Journal of Cardiovascular Diseases

摘　　要：目的以右心室造影为对照,使用超声心动图常规的四腔心切面和全新的右心室全显示切面定量评价右心室射血分数(right ventricular ejection fraction,RVEF),探讨右心室全显示切面在右心功能评价中的应用价值。方法2011年4月至2011年11月通过临床和超声心动图检查选择伴有右心室形态或血流动力学改变的先天性心脏病患者22例(男13例,女9例,年龄16～67岁)为研究对象。除对入选患者行常规的超声心动图检查外,还使用四腔心切面和右心室全显示切面测量RVEF。在心导管实验室使用右心室造影测量RVEF。将四腔心和右心室全显示切面RVEF与右心室造影RVEF行随机区组设计方差分析及Pearson相关性分析,右心室全显示切面RVEF与其余右心功能指标行Pearson相关分析,并采用Bland-Altman法评价右心室全显示切面与右心室造影的一致性。结果3种方法测得的RVEF分别为右心室全显示切面48.0%±11.3%、四腔心切面49.5%±13.1%、右心室造影48.7%±12.1%。3种方法测量结果比较,差异无统计学意义(F=0.327,P=0.723)。右心室全显示切面RVEF与右心室造影RVEF呈高度相关(r=0.908,P<0.001),四腔心切面RVEF与右心室造影RVEF呈中度相关(r=0.659,P=0.001)。右心室全显示切面RVEF与肺动脉收缩压及主肺动脉宽度负相关(P<0.05),与右心室每搏输出量正相关(P<0.05),与其他右心功能评价指标则无明显相关性。结论与常规的四腔心测量方法相比,超声心动图右心室全显示切面测量的RVEF与右心室造影的相关性更好,可能是一种准确和可靠的评价右心室收缩功能的方法。Objectives A novel method was developed for calculating right ventricular ejection fraction （RVEF） from total right ventricular view of two-dimensional echocardiography, and was compared with the conventional four chamber view and right anterior oblique view of fight ventrieular angiography. The echocardiographie estimation of right ventrieular function was discussed. Methods From April 2011 to November 2011, 22 patients with congenital heart disease combined with right ventricular dilatation or abnormal hemodynamies （13 males and 9 females, aged from 16 to 67） were admitted into our institute. RVEF was calculated from two cross-sectional echocardiographic views： four chamber view and total right ventrieular view. In the cardiac catheterization laboratory, RVEF was calculated from fight anterior oblique view of right ventricular angiography. ANOVA and Pearson correlation analysis were used for RVEFs from three views. RVEF of total right ventricular view and other right ventricular function parameters underwent Pearson correlation analysis. Bland-Ahman plot was used to evaluate the consistency of the two techniques. Results RVEFs measured by the three methods were 48.0 %± 11.3% （total right ventricular view）, 49.5%±13.1% （four chamber view） and 48.7%± 12.1% （fight ventrieular angiography） respectively. They had no statistical significance （F=0.327, P= 0.723 ）. RVEF of total right ventricular view and RVEF of fight ventricular angiography were highly correlated （r=0.908, P〈0.001 ）, while RVEF of four chamber view and RVEF of right ventricular angiography were moderately correlated （r= 0.659, P=0.001 ）. RVEF of total right ventricular view was negatively correlated with pulmonary artery systolic pressureand main pulmonary artery diameter （P〈0.05）, positively correlated with right ventricular stroke volume （P〈0.05）, and had no significant correlation with other indexes of right ventricular function. Conclusions This study confirms that RVEF of total right ventricular

关 键 词：心脏缺损 先天性 右心室造影 右心室射血分数 右心室全显示切面 

分 类 号：R541.1[医药卫生—心血管疾病]