肝中静脉血流频谱变化对肺动脉高压诊断的临床评价  

Clinical Evaluation of Doppler Spectra Changes of Middle Hepatic Vein in Diagnosing of Pulmonary Hypertension

作　　者：孙丹丹[1] 段云友[2] 侯颖[2] 侯传举[3] 尚福军[4] 庚靖淞[3] 周方平[5] 

机构地区：[1]吉林医药学院口腔影像系,吉林省吉林市132013 [2]第四军医大学唐都医院超声科 [3]沈阳军区总医院先心病内科 [4]第四军医大学唐都医院心内科 [5]吉林医药学院附属医院特诊科,吉林省吉林市132013

出　　处：《中国超声医学杂志》2015年第4期336-339,共4页Chinese Journal of Ultrasound in Medicine

基　　金：吉林省科技发展计划项目(No.20130522016JH);吉林市科技计划项目(No.201464046)

摘　　要：目的分析肺动脉高压患者肝中静脉血流多普勒频谱的变化规律,筛选适合临床使用的诊断肺动脉高压的新指标。方法收集预行封堵术的先天性心脏病患者80例,经右心导管测量其肺动脉压力,经超声测量肝中静脉频谱各波的峰值速度(V)和速度时间积分(VTI),评价其对肺动脉高压的预测价值,确定截断点。结果与对照组相比,肺动脉高压组SV、SVTI、DV、DVTI降低,ARV、ARVTI、ARV/SV、ARVTI/SVTI、ARV/(SV+DV)、ARVTI/(SVTI+DVTI)升高,差异具有统计学意义(P<0.05)。相关分析显示ARV/SV、ARV/(SV+DV)、ARVTI/(SVTI+DVTI)比值与肺动脉平均压具有相关性(r=0.529、0.575、0.438,P均<0.001)。ROC曲线分析结果显示ARV/(SV+DV)比值对于肺动脉高压的诊断效果优于其他参数,ARV/(SV+DV)比值=0.30时,对肺动脉高压诊断的灵敏度85.37%、特异度75.00%。结论以肝中静脉ARV/(SV+DV)比值=0.30为界值,诊断肺动脉高压具有较好的灵敏度及特异度,可以作为超声心动图评价肺动脉高压指标的有力补充。Objective The aim of this study was to analyze Doppler spectra of middle hepatic vein （MHV） in patients with pulmonary hypertension （PH）,and screen the proper parameters of MHV to predict PH.Methods Eighty patients with congenital heart disease,who underwent right heart catheterization for the measurement of pulmonary artery pressure,were included.MHV Doppler ultrasound was performed before the catheterization,and the velocity （V） and velocity time integral （VTI）of waves were measured.The value of MHV parameters in the prediction of PH was evaluated and the cut-off point was determined.Results Compared with the control group,SV,SVTI,DV,DVTI decreased and ARV,ARVTI,ARV/SV,ARVTI/SVTI,ARV/（SV＋DV）,ARVTI/（SVTI＋DVTI） increased in PH group,the differences were statistically significant （P＜0.05）.Correlation analysis showed that ratios of AR/S,AR/（S＋D）,ARVTI/（SVTI＋DVTI） were positively correlated with pulmonary artery mean pressure （r=0.529,0.575,0.438,P＜0.001）.ROC curve analysis showed that the diagnostic effect of ARV/（SV＋DV） was superior to other parameters.On the ROC curve,when the ratio of ARV/（SV＋DV） was 0.30,it had a sensitivity of 85.37％ and a specificity of 75.00％ to predicting patients with PH.Conclusions When the ratio of ARV/（SV＋DV）was 0.30 in MHV flow,it had a fine sensitivity and specificity to diagnose PH.It could be used as a new non-invasively complementary echocardiographic parameter to predict PH.

关 键 词：肺动脉高压 肝中静脉 超声检查 右心导管 

分 类 号：R544.1[医药卫生—心血管疾病] R445.1[医药卫生—内科学]