实时三维超声心动图评价肺栓塞患者右心室形态及功能的研究  

Assessment of right ventricular morphology and function in patients with pulmonary embolism by real-time three-dimensional echocardiography

作　　者：黄喜玉[1] 吴棘[1] 郭盛兰[1] 何云[1] 李群[1] 罗小菊[1] 郭丽萍[1] 

机构地区：[1]广西医科大学第一附属医院超声科,南宁市530021

出　　处：《临床超声医学杂志》2013年第5期292-294,共3页Journal of Clinical Ultrasound in Medicine

基　　金：国家自然科学基金(30960362)

摘　　要：目的探讨实时三维超声心动图(RT-3DE)评价肺栓塞患者右心室形态及功能变化的临床价值。方法 28例肺栓塞患者根据早期病死率进行危险分层,分为高危组8例,中危组12例,低危组8例,30例体检健康者为对照组。应用二维超声心动图测量其右心常规超声指标,RT-3DE测量右心室舒张期末容积(RVEDV)、收缩期末容积(RVESV)、每搏输出量(RVSV)及射血分数(RVEF)。结果与对照组比较,肺栓塞高危组肺动脉压增高,右心增大(P<0.05);中危组肺动脉压轻度增高,但右心无明显增大;低危组均无右心增大和肺动脉高压。与对照组比较,肺栓塞中危组和高危组RVEDV、RVESV均增大,RVEF降低(P<0.05),低危组则无明显变化;且从低危组至高危组,RVEDV、RVESV递次增大,RVEF递次减小;各组间RVSV比较,差异无统计学意义。结论 RT-3DE可客观、准确、较敏感反映肺栓塞患者右心室形态与功能变化,是评价其右心室功能的较好方法。Objective To explore the clinical application value of real-time three-dimensional echocardiography （RT- 3DE ） in evaluating right ventricular morphology and function of patients with pulmonary embolism （PE）. Methods Twenty-eight patients with PE were divided into 3 subgroups according to the expected PE-related early mortality, 30 healthy subjects as control group. Some traditional ultrasonic parameters of fight heart,right ventricular end-diastolic volume （RVEDV）, right ventrieular end-systolic volume （RVESV）, right ventricular stroke volume （RVSV） and right ventricular ejection fraction （RVEF） were evaluted in all subjects. Results There was characteristic eehocardiographic appearance of right ventrieular dilation and pulmonary hypertension in high risk group of patients with PE. Moderate risk group had mild pulmonary hypertension, but no dilated right ventricle. In low risk group, there was neither dilated right ventricle nor pulmonary hypertension. Compared with the control group, the RVEDV and RESV of high and moderate risk group were significantly increased （P 〈 0.05）, while RVEF was all significantly decreased （P 〈 0.05）. There was no significant difference in low risk group. Then from the low risk group to the high risk group, RVEDV, RVESV were gradually increased, RVEF was gradually decreased. There was no significant difference of RVSV in each group. Conclusion RT-3DE can objectively, accurately and sensitively reflect the changes in right ventrieular morphology and function of patients with PE, it is a better method to evaluate the right ventrieular function.

关 键 词：超声心动描记术 实时 三维 肺栓塞 肺动脉高压 心室功能 右 

分 类 号：R540.45[医药卫生—心血管疾病] R445.1[医药卫生—内科学]