Tei指数评价海滨疗养对高原肺动脉高压患者右室功能的康复作用  

Rehabilitative effect of seaside recuperation on right ventricular function in patients with high-altitude pulmonary hypertension evaluated by Tei index

作　　者：郑芳[1] 戴蓉[1] 何胜洪[1] 

机构地区：[1]南京军区鼓浪屿疗养院影像科,福建厦门361002

出　　处：《心血管康复医学杂志》2013年第6期616-619,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的：应用Tei指数评价鼓浪屿海滨综合疗养对高原肺动脉高压患者右室功能的康复作用。方法：选择平原地区正常成人20例为平原正常组，高原地区观察者73例[按肺动脉压的程度分为：正常组（20例）、轻度组（20例）、中度组（18例）、重度组（15例）]，所有观察对象均参与15～30d的鼓浪屿海滨综合疗养，并于疗养前、后行心脏超声检查，测量传统右心室参数：右室前后径（RVD）、右房横径（RAD）、肺动脉主干内径（PA）、三尖瓣舒张期血流峰值比值（E／A），右室射血分数（RVEF）；同时运用脉冲多普勒技术测量并计算出右室Tei指数（RV—Tei），并作疗养前后比较。结果：（1）疗养前，与平原正常组比较，高原正常组，高原肺动脉压组右心功能均有显著异常，高原肺动脉压组的最差，3组间两两比较，P均〈0．01；（2）疗养后高原肺动脉高压各组的RV—Tei指数较疗养前有显著改善[轻度：（0．46±0．08）比（0．49±0．09），中度：（0．59±0．11）比（0．61±0．11），重度：（0．70±0．10）比（0．74±0.10），P〈0．05～〈0.01]，而传统右心参数仅有轻度组和中度组的E／A较疗养前有显著改善（P均〈0．05）。结论：鼓浪屿海滨综合疗养对高原肺动脉高压患者的右心室功能有积极地康复作用。右室Tei指数优于传统右心参数，是评价高原肺动脉高压患者右心室功能康复的敏感指标。Objective： To evaluate rehabilitative effect of Gulangyu seaside synthetic recuperation on right ventricular function in patients with high-altitude puimonary hypertension （HAPH） using Tel index. Methods： A total of 20 normal adults from plain district were enrolled as plain normal group. According to level of pulmonary arterial pressure, a total of 73 cases from plateau district were divided into plateau normal group （n = 20）, mild HAPH group （n = 20）, moderate HAPH group （n = 18） and severe HAPH group （n = 15）. All subjects participated in 15-30d Gulangyu seaside synthetic recuperation, and they received echocardiography before and after recuperation. Traditional right ventricular indexes, including right ventricular anteroposterior diameter （RVD）, right atrial transverse diameter （RAD）, tricuspid valve diastolic peak flow ratio （E/A） and right ventricular ejection fraction （RVEF） were measured; meanwhile, pulsed wave Doppler echocardiography was used to measure and calculate right ventricular Tei index （RV - Tei）, the results were compared before and after recuperation. Results： （1） Before recuperation, compared with plain normal group, there were significant abnormality of right ventrieular function in plateau normal group and plateau HAPH group, and those of plateau HAPH group were worse; compared among three group, the P were 〈0.01 all; （2） Compared with before recuperation, there were significant improvements in RV- Tel indexes [mild： （0.49 ± 0.09） vs. （0.46 ± 0.08）, moderate： （0.61 ± 0.11） vs. （0. 59 ± 0.11）, severe： （0.74 ± 0.10） vs. （0.70 ± 0.10）, P〈0.05-〈0. 011 in all groups of HAPH, but for traditional right heart indexes, there were significant improvements only E/A of mild HAPH and moderate HAPH group （P〈0.05 all）. Conclusion： Gulangyu seaside synthetic recuperation possesses active rehabilitative effect on right ventricular allomeric function in patients with high-altitude pulmonary hypertensi

关 键 词：海滨浴场 高血压 肺性 心室功能 右 TEI指数 

分 类 号：R543.209[医药卫生—心血管疾病]