超声心动图评价右室收缩功能及其预测缩窄性心包炎患者心包剥脱术后疗效的价值  

The Prognostic Value of Right Ventricular Systolic Function Assessed by Echocardiography in Constrictive Pericarditis Underwent Pericardiectomy

作　　者：刘爽[1] 任卫东[2] 马春燕[1] 杨军[1] 张妍[2] 王永槐[1] 李阳[1] 

机构地区：[1]中国医科大学附属第一医院心血管超声科,沈阳市110001 [2]中国医科大学附属盛京医院超声科

出　　处：《中国超声医学杂志》2017年第3期235-237,共3页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然基金面上项目(No.81571686)

摘　　要：目的应用超声心动图评价缩窄性心包炎(CP)患者右室收缩功能,并探讨其预测患者心包剥脱术后心脏不良事件的价值。方法对36例行心包剥脱术的CP患者及32例正常对照组采用超声心动图测量右室面积变化率(RVFAC)、三尖瓣环位移(TAPSE)。CP患者心包剥脱术后随访是否发生心脏不良事件(充血性心力衰竭或心源性死亡)。结果与对照组相比,CP患者TAPSE及RVFAC较正常人显著减低,(P<0.05)。(2.8±1.7)年的随访后,CP患者中有7例(19%)发生不良事件(ACE组),其余29例(81%)未发生不良事件(NACE组)。ACE组TAPSE明显小于NACE组(P<0.05)。TAPSE是预测心包剥脱术后不良事件的敏感因子,阈值为17.5mm,灵敏度和特异度为87%及82%。结论 CP患者右室收缩功能减低,TAPSE可以预测心包剥脱术后是否发生心脏不良事件,为临床治疗方案的选择及预后评价提供可信赖的指标。Objective To evaluate the right ventricular （RV） function in patients with constrictive pericarditis （CP） using echocardiography, and its value in predicting adverse cardiac events after pericardiectomy. Methods 36 patients with CP and 32 normal subjects were enrolled in the study. The right ventricular fractional area change （RV- FAC） and tricuspid annular plane systolic excursion （TAPSE） were measured. Post-operative events including conges- tive heart failure and cardiac death were recorded in the patients with CP. Results TAPSE and RVFAC were significantly decreased in patients with CP （P（0.05）. After （2.8± 1.7） years follow-up, 7 patients （19%） occurred ad- verse cardiac events （ACE group） while others （81%） didn＇t have adverse cardiac events （NACE group）. The TAPSE was significantly reduced in ACE group （P（0.05）, which was the most sensitive factor to predict the adverse cardiac events after pericardiectomy with a cutoff value of 17.5 mm, the sensitivity and specificity are 87% and 82 % respectively. Conclusions The RV function was reduced in patients with CP, and TAPSE can predict the adverse cardiac events after pericardiectomy, which provides reliable data in CP management and prognostic evaluation.

关 键 词：缩窄性心包炎 心包剥脱术 疗效 超声心动图 

分 类 号：R540.45[医药卫生—心血管疾病]