组织多普勒室壁运动时间对肺动脉高压患者右室功能的评价  

Assessment of right ventricular function in patients with pulmonary hypertension using tissue Doppler imaging time intervals

作　　者：薛明华[1] 张琴[2] 侯代伦[1] 王星[2] 王磌[2] 隋树建[3] 

机构地区：[1]山东省胸科医院超声科,山东济南250013 [2]山东省交通医院超声科,山东济南250031 [3]山东大学第二医院心内科,山东济南250033

出　　处：《心脏杂志》2013年第5期547-550,557,共5页Chinese Heart Journal

基　　金：山东省交通厅科技项目资助(2006Y024)

摘　　要：目的:利用脉冲组织多普勒技术(PW-TDI)测量右室室壁运动时间间期评价肺动脉高压(PH)患者右心功能的变化。方法:PH患者150例,根据PH的程度分为轻度组、中度组、重度组,每组50例,应用PW-TDI测量心尖四腔心切面三尖瓣前瓣瓣环心肌运动的时间间期指标包括:电-机械时间(EMD)、射血前期(PEP)、等容收缩时间(ICT)、心室射血时间(ET)、等容舒张时间(IRT)、充盈时间(FT),计算Tei指数。将PH组与正常对照组的心肌运动时间间期参数进行比较,通过统计分析了解不同程度PH患者右心功能变化。结果:与正常对照组比较,轻度组IRT延长(P<0.01);中度组IRT延长、FT缩短(均P<0.01);重度组IRT、ICT和PEP延长、ET和FT缩短(均P<0.01)。Tei指数在PH组均增大(均P<0.01)。中度组较轻度组、重度组较轻度组、重度组较中度组IRT延长、FT缩短(均P<0.05);重度组较轻度组ICT和PEP延长、ET缩短、Tei指数增大(均P<0.05)。EMD在不同水平PH组和正常对照组间无显著性差异。结论:PH导致右室收缩和舒张功能降低,舒张功能降低早于收缩功能降低。AIM： To explore the changes of right ventricular function in patients with pulmonary hypertension （PH） using time intervals of right ventrieular motion from pulsed-wave tissue Doppler imaging （PW-TDI）. METHODS ： One hundred and fifty PH patients and 60 age-matched controls were studied. Patients were divided into three PH groups according to their PH level. PW-TDI was used to record the anterior tricuspid annulus motion in the apical four-chamber view. Parameters of time intervals including electromechanical delay （EMD）, isovolumetric contraction time （ICT）, pre-ejection period （PEP）, ejection time （ET）, isovolumetric relaxation time （IRT） and filling time （FT） were measured and Tei index was calculated. Data were analyzed with statistical software. RESULTS： Compared with control group, IRT in mild PH group was prolonged （P 〈 0. 01 ）, and IRT was prolonged and FT shortened in moderate PH group （P 〈0. 01）. In severe PH group, IRT, ICT and PEP were prolonged, whereas ET and RF were shortened （P 〈 0. 01 ）. Tei index in PH groups all significantly increased compared with control group （P 〈 0. 01 ）. Statistical differences in IRT and FT were found between severe group and mild group and moderate group （ P 〈 0. 05 ）. ICT, PEP, ET and Tei index were significantly different between severe PH group and mild PH group （ P 〈 0. 05 ）. No significant difference in EMD was observed among the three PH groups and control group. CONCLUSION ： PH leads to the dysfunction of the right ventricle. Right ventricular diastolic dysfunction happens in the early stage of PH and precedes systolic dysfunction in PH patients.

关 键 词：组织多普勒成像 肺动脉高压 时间间期 心室功能 

分 类 号：R543.2[医药卫生—心血管疾病] R730.41[医药卫生—内科学]