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作 者:张兰[1] 王志刚[1] 任建丽[1] 罗田田[1] 卢岷[1] 刘凤琴[1]
机构地区:[1]重庆医科大学超声影像学研究所及附属第二医院超声科超声分子影像重庆市重点实验室,重庆市400010
出 处:《中国超声医学杂志》2015年第4期315-318,共4页Chinese Journal of Ultrasound in Medicine
基 金:国家自然科学基金(No.81471675);重庆市医学科研计划项目(No.20142035);重庆市科委科技项目(No.cstc2014jcy jA10031)
摘 要:目的应用实时三维超声心动图(RT-3DE)评价左心疾病相关性肺高血压(LHD-PH)患者右室重构过程,初步探讨RT-3DE相关参数对被动性PH与反应性PH的鉴别诊断价值。方法健康志愿者40例,LHD-PH患者65例,根据肺血管阻力(PVR)将PH患者分为:被动性PH组和反应性PH组。应用RT-3DE测量右室舒张末期容积指数(RVVId)、收缩末期容积指数(RVVIs)、每搏量(RVSV)和射血分数(RVEF)。结果与对照组比较,PH亚组RVVId、RVVIs和RVSV增加,反应性PH组RVEF减低(均P<0.05);与被动性PH组比较,反应性PH组RVVId、RVVIs升高,RVEF降低(均P<0.05)。ROC分析显示,RVEF、RVVId、RVVIs分别为37.25%、42.03ml/m2、26.42ml/m2时,其鉴别被动性PH与反应性PH的灵敏度分别为72%、66%、62%,特异度分别为75%、75%、78%。结论 RT-3DE能定量评价LHD-PH患者右室重构过程;RVEF、RVVId和RVVIs在被动性PH与反应性PH的鉴别诊断中有一定临床价值。Objective To evaluate the remodeling of right ventricular in patients with pulmonary hypertension due to left heart disease(LHD-PH) using real-time 3D echocardiography (RT-3DE),and to explore the value of related parameters for differential diagnosis of passive PH and reactive PH.Methods Totally 40 controls and 65 patients with LHD-PH were enrolled.According to pulmonary vascular resistance (PVR),patients were divided as:passive PH and reactive PH group.RT-3DE derived right ventricular end-diastole volume index (RVVId),end-systole volume index (RVVIs),stroke volume (RVSV) and ejection fraction (RVEF) were measured.Results Compared with controls,RVVId,RVVIs and RVSV were higher in PH subgroups,and RVEF in reactive PH group was lower (all P<0.05).RVVId and RVVIs were higher and RVEF was lower in reactive PH group than passive PH group (all P<0.05).Diagnostic efficacy of related parameters were tested by ROC curve.When the cut off value of RVEF,RVVId and RVVIs were 37.25%,42.03 ml/m2 and 26.42 ml/m2,the sensibility were 72%,66% and 62%,and the specificity were 75%,75% and 78%,respectively.Conclusions Right ventricular remodeling can be evaluated by RT-3DE in patients with LHD-PH.RVEF,RVVId and RVVIs have certain value in differentiating between passive PH and reactive PH.
关 键 词:实时三维超声心动图 右心室功能 肺高血压 左心疾病
分 类 号:R445.1[医药卫生—影像医学与核医学] R544.1[医药卫生—诊断学]
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