采用多普勒超声心动图无创性估测叁期尘肺患者肺血管阻力  

Noninvasive Assessment of Pulmonary Vascular Resistance by Doppler Echocardiography in Patients with Pneumoconiosis at Stage Three

作　　者：邓晓丽[1] 朱林平[2] 吴棘[1] 蒋春兰[1] 杨金平[2] 

机构地区：[1]广西医科大学第一附属医院超声科,广西530021 [2]广西壮族自治区职业病防治研究院,广西530021

出　　处：《环境与职业医学》2015年第9期870-872,875,共4页Journal of Environmental and Occupational Medicine

基　　金：广西自然科学基金项目(编号:0832220)

摘　　要：[目的]运用多普勒超声心动图估测叁期尘肺患者的肺血管阻力,并探讨该方法在估测肺血管阻力的临床应用价值。[方法]选择叁期尘肺患者38人(尘肺组)与健康志愿者40人(对照组)为研究对象,采用多普勒超声心动图分别测量两组人群右室流出道内径(DRVOT)、右室流出道血流速度时间积分(VTIRVOT)、三尖瓣反流速度峰值(TRV)及反流压差、三尖瓣环收缩期峰值速度(t Sm)、左室射血分数(LVEF),应用两种估测肺血管阻力(PVR)计算方法,PVRecho1=5.19·TRV2/VTIRVOT,PVRecho2=3 698-1 227·ln(t Sm);估测肺动脉收缩压(PASP);根据右心输出量(CO)计算心脏指数(CI)=CO/体表面积。比较两组间各指标值的差异。[结果]尘肺组PASP、PVRecho1,PVRecho2均明显高于对照组(74.99±18.04)、(30.98±2.83)mm Hg,(6.30±1.68)、(1.45±0.29)WU,(607.22±76.74)、(385.51±76.95)dynes/cm5,均P<0.01;DRVOT及TRV均大于对照组,分别为(25.07±1.05)、(20.84±0.67)mm,(3.55±0.18)、(2.24±0.13)m/s,均P<0.05;尘肺组和对照组的VTIRVOT分别为(13.44±1.20)、(15.46±0.65)mm,t Sm分别为(12.71±0.59)、(15.09±1.05)mm,均为尘肺组低于对照组(P<0.05)。[结论]多普勒超声心动图估测Ⅲ期尘肺患者的肺血管阻力,无创且简单易行,对临床医生有一定的参考依据。[ Objective ] To estimate the pulmonary vascular resistance by Doppler echocardiography in patients with pneumoconiosis at stage three, and to explore the clinical value of this appliction in estimating pulmonary vascular resistance. [ Methods ] Thirty-eight patients with pneumoconiosis at stage three and forty normal control subjects were enrolled. Measurements by Doppler echocardiography included right ventricular outflow tract diameter （DRvoT）, time velocity integral of right ventricular outflow tract （VTIRvoT）, tricuspid regurgitation peak velocity （TRV） and regurgitation pressure, systolic peak velocity of tricuspid annulus （tSm）, and left ventricular ejection fraction （LVEF）. Pulmonary vascular resistance （PVR） was estimated by the following two methods： PVRechol=5.19·TRW/VTIRVOT and PVRecho2=3 698-1 227 ·ln （tSm）. Pulmonary artery systolic pressure （PASP） was also estimated. Heart index （CI） was calculated by CI=right cardiac output （CO）/BSA. All indicators were compared between the two groups. [ Results ] Compared with the normal control group, the PASP, PVRecho1, and PVReoho2 were significantly higher in the stage three pneumoeoniosis patients [（74.99 ± 18.04） mmHg vs. （30.98 ± 2.83） mmHg, （6.30 ± 1.68） Wu vs. （1.45 ± 0.29） Wu, （607.22 ± 76.74） dynes/cm5 vs. （385.51± 76.95） dynes/cm5, respectively, all P〈0.01]. So were the DavoT and TRV [（25.07 ± 1.05） mm vs. （20.84 ± 0.67） mm, （3.55 ± 0.18） m/s vs. （2.24 ± 0.13） m/s, respectively, both P〈 0.05]. However, the VTIRvoT and tSm were lower [（13.44±1.20） mm vs. （15.46± 0.65） nun, （12.71 ± 0.59） mm vs. （15.09 ± 1.05） mm, respectively, both P 〈 0.05]. [ Conclusion ] Estimating pulmonary vascular resistance in patients with pneumoconiosis at stage three by Doppler eehocardiography is noninvasive and convenient in operation, which is expected to provide useful information for relevant physicians.

关 键 词：多普勒超声心动图 无创性 叁期尘肺 肺血管阻力 

分 类 号：R135.2[医药卫生—劳动卫生]