超声心动图对不同右心构型三尖瓣反流速度测量切面的研究  

Research on Measurement Views of Tricuspid Regurgitation Velocity in Different Configuration of Right Heart by Echocardiography

作　　者：王竞[1] 康彧[2] 张嬿[2] 何兰芳[2] 王渠[2] 胡敏[2] 

机构地区：[1]成都中医药大学临床医学院,成都市610072 [2]成都中医药大学附属医院超声医学科

出　　处：《中国超声医学杂志》2016年第5期434-437,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的运用超声心动图探讨不同右心构型功能性三尖瓣反流速度的测量切面。方法选取经胸超声心动图检查的功能性三尖瓣反流成人患者80例。根据右心房室大小分为右心大小正常组和右心增大组。多切面观察反流束方向,测量声束-反流束夹角(θ)以及三尖瓣反流速度(TRV)。结果 (1)在不同切面测量获取的TRV存在不一致性,67.5%位于1.96倍标准差区间之外。(2)TRVmax中θ角<20°占93.8%(75/80);胸骨旁四腔心平均θ值比心尖四腔切面更小(P<0.01)。(3)TR束具有多方向性,右心大小正常组中心性与偏心性反流频数差异无统计学意义(P>0.05),右心增大组以中心性反流为主(P<0.01)。(4)偏心性TRVmax主要集中于胸骨旁右室流入道长轴和胸骨旁四腔切面,偏心性TRV平均值在上述切面差异无统计学意义(P>0.05);中心性TRVmax主要集中于胸骨旁四腔切面,与其他切面比较,差异有统计学意义(P<0.01),中心性TRV平均值在该切面最大,差异有统计学意义(P<0.05)。结论分析不同右心构型TR特点,有助于经胸超声心动图选择TRV测量切面,提高测值准确度。Objective To explore the views to measure functional tricuspid regurgitation velocity in different configuration of right heart by echocardiography.Methods 80 adult patients with functional tricuspid regurgitation examined by transthoracic echocardiography.According to the size of right atrium（RA）and right ventricle（RV）,cases were divided into two groups：the normal group and the enlargement group.The regurgitation direction was observed respectively in four views,and the angle（θ）between sound beam and regurgitation jet and tricuspid regurgitation velocity（TRV）were measured.Results（1）The TRV in different views were inconsistency and 67.5% were out of the1.96 standard deviation interval.（2）The angle（θ）of 93.8% TRVmax were less than 20°.Comparing the view of parasternal 4-chamber with apical 4-chamber,the former could get smaller averageθ（P〈0.01）.（3）As TR jet was multidirectional,the frequency between the central regurgitation and the eccentric regurgitation in the normal group were no significant difference（P〈0.05）,while the right heart enlargement group was mainly the central regurgitation（P〈0.01）.（4）The eccentric maximum TRV was focus on the views of parasternal RV inflow long-axis and parasternal4-chamber,yet eccentric TRV average values in these views were no significant difference（P〈0.05）;The central maximum TRV was focus on the view of parasternal 4-chamber,there were significant difference comparing with other views respectively（P〈0.01）,while central TRV average value in this view was maximal comparing with others（P〈0.05）.Conclusions To study the feature of TR in different configuration of right heart,it was helpful to choose the measurement view of TRV and increase the measurement accuracy.

关 键 词：超声心动描记术 三尖瓣反流 速度 切面 

分 类 号：R540.45[医药卫生—心血管疾病] R542.5[医药卫生—内科学]