组织多普勒技术及M型超声在评估风湿性心脏病右室功能中的应用  

The application PW-TDI and M-mode in evaluation of right ventricular function by in patients with rheumatic heart disease

作　　者：李贺智[1,2] 费洪文[1,2] 黄奕高[1,2] 陈烁[1,2] 朱伟[1,2] 郭惠明[1,2] 陈泗林[1,2] 

机构地区：[1]广东省心血管病研究所 [2]广东省人民医院(广东省医学科学院)心内科,广州510080

出　　处：《广东医学》2013年第10期1505-1508,共4页Guangdong Medical Journal

基　　金："十二五"国家科技支撑项目(编号:2011BAI11B19)

摘　　要：目的通过测量三尖瓣环组织多普勒收缩期峰值速度(TA Sa)及M型运动位移(TAPSE),探讨风湿性心脏病患者不同程度肺动脉高压之间右室功能变化。方法以72例风湿性心脏病患者为研究对象,应用组织多普勒成像技术(PW-TDI)及M型超声测量TA Sa及TAPSE,并测量计算心尖四腔心右室的面积变化分数(RVFAC),比较TA Sa、TAPSE及RVFAC在27例健康对照者与轻、中、重度肺动脉高压者之间的差异。结果随着肺动脉收缩压的增加,TA Sa及TAPSE呈明显下降趋势,组间差异有统计学意义(P<0.01),其中重度肺动脉高压者TA Sa、TAPSE较其他研究对象明显下降,差异有统计学意义(P<0.05)。同时TA Sa、TAPSE与RVFAC之间呈正相关(r=0.615,P<0.01;r=0.558,P<0.01)。结论 TA Sa、TAPSE与RVFAC相关性良好,能有效、敏感地评价风湿性心脏病右室功能变化。Objective To evaluate the application of tricuspid annular systolic velocity （TA Sa） and tricuspid annular plane systolic excursion （TAPSE） in right ventricular function （RVF） assessing of patients with rheumatic heart disease （RHD）. Methods 72 RHD patients were enrolled and divided into three groups base on pulmonary hypertension （PH） level; meanwhile, 27 healthy subjects were enrolled as controls. TA Sa, TAPSE, and RVFAC were evaluated in all subjects. Results TA Sa and TAPSE were significantly reduced as the increase of severity of PH. The TA Sa and TAPSE in severe PH group were significantly lower than those in the other groups （P 〈 0. 01 ）. Furthermore, TA Sa and TAPSE were significantly positively correlated with RVFAC （r = 0. 615, P 〈 0. 01 ; r = 0. 558, P 〈 0. 01 ）. Conclusion TA Sa and TAPSE show positive correlation with RVFAC, providing effective and sensitive predictors for RVF of RHD patients.

关 键 词：组织多普勒 M型位移 右室面积变化分数 风湿性心脏病 

分 类 号：R541.2[医药卫生—心血管疾病]