两种超声心动图方法与右心导管检测室间隔缺损患者肺动脉收缩压的对比研究  

Comparative study of right heart catheterization and two methods of echocardiography to measure pulmonary artery systolic pressure in patients with ventricular septal defect

作　　者：左思阳[1] 陈昆迪[1] 闫瑞玲[1] 雷春霞 

机构地区：[1]兰州军区兰州总医院超声诊断科,甘肃兰州730050 [2]张掖市中医院功能科,甘肃张掖734000

出　　处：《西部医学》2014年第4期477-479,共3页Medical Journal of West China

基　　金：全军医药卫生科研项目(lxh-2012026)

摘　　要：目的对比两种超声心动图压力测算法与右心导管检测对室间隔缺损患者肺动脉收缩压的差异,并进行分析评估。方法 175例室间隔缺损患者分别使用室水平分流测算法和三尖瓣反流压差测算法对肺动脉收缩压进行测量,并对结果进行比较分析;对其中102例患者行右心导管检查,与超声心动图两种方法测量的结果进行对比分析。结果超声心动图两种方法测算的肺动脉收缩压压力结果有较好的相关性(r=0.828,P=0.000),但是当室水平分流速度>4m/s时,两种方法存在显著性差异(P<0.05);102例行右心导管检查测量肺动脉收缩压与超声心动图测量结果比较,当室水平分流测算法和三尖瓣反流压差测算法之差<20mmHg时,三种方法测量的结果无显著性差异(P>0.05);当室水平分流测算法和三尖瓣反流压差测算法之差>20mmHg时,三种方法结果有显著性差异(P<0.05),而室水平分流测算法与右心导管检查估测的结果无显著性差异(P>0.05)。结论室水平分流测算法和三尖瓣反流压差测算法估测的肺动脉收缩压有较好的相关性,当两种测算结果存在较大差异(>20mmHg)时,三尖瓣反流压差测算法容易产生误差,室水平分流计算法结果较为准确。Objective To study the different way measure pulmonary artery systolic pressure by right heart catheterization and two methods of echocardiography in patients with ventricular septal defect.Methods 175 patients with VSD were used pressure gradient of ventricular shunting method and tricuspid regurgitation pressure gradient method for pulmonary artery systolic pressure were measured,and the result was compared and analyzed.102 of these patients underwent right heart catheterization were compared with two methods ultrasonic results.Results Two methods of ultrasonic results had good correlation （r=0.828,P=0.000）,but when ventricular shunts was faster than that of 4m/s,there was a significant difference between the two methods （P＜0.05）.102 cases underwent right heart catheterization and two methods of echocardiography to measure the pulmonary systolic pressure.When pressure gradient of ventricular shunting method and three tricuspid regurgitation pressure measuring method was less than 20mmHg,no significant differences between the three methods of measuring results （P＞0.05）; when the ventricular shunts calculation method and t tricuspid regurgitation pressure gradient method measuring more than 20mmHg.Results of the three methods have significant difference （P＜0.05）,but the Pressure gradient of ventricular shunting method estimation and right heart catheterization showed no significant difference （P＞0.05）.Conclusion Tricuspid regurgitation pressure gradient method and pressure gradient of ventricular shunting method measurement pulmonary artery systolic pressure has good correlation,but the two kinds of measurement results exist bigger difference （＞ 20mmHg）,Tricuspid regurgitation pressure gradient method is prone to errors,Pressure gradient of ventricular shunting method of result are more accurate.

关 键 词：肺动脉收缩压 右心导管检查 三尖瓣反流压差法 室水平分流压差法 

分 类 号：R445.1[医药卫生—影像医学与核医学]