实时三维超声心动图评估功能性三尖瓣反流患者的三尖瓣环形态改变  

Evaluation of three-dimensional geometry of tricuspid annulus in patients with functional tricuspid regurgitation using real-time three-dimensional echocardiography

作　　者：吴文谦 杨亚利 王薇[2] 张丽 王斌[1] 段依恋 Wu Wenqian Yang Yali Wang Wei Zhang Li Wang Bin Duan Yilian(Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Key Laboratory of Molecular Imaging, Wuhan 430022, Chin)

机构地区：[1]华中科技大学同济医学院附属协和医院超声影像科,湖北省分子影像重点实验室,武汉430022 [2]武汉大学中南医院超声影像科,武汉430022

出　　处：《中华超声影像学杂志》2017年第9期743-747,共5页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金（81000615）

摘　　要：目的应用实时三维超声心动图观察功能性三尖瓣反流（FTR）患者的三尖瓣环立体形态改变。方法75例FTR患者根据反流量及瓣环横径分为4组：A组21例，瓣环横径增大且反流≥中量；B组18例，三尖瓣环横径增大且反流〈中量；c组19例，瓣环横径正常且反流≥中量；D组17例，瓣环横径正常且反流〈中量。健康志愿者21例为对照组（E组）。应用实时三维超声心动图测量瓣环前后径（AP）、瓣环左右径（SM）、瓣环圆形指数（SI）、瓣环非平面角度（NPA）、三尖瓣环前半侧瓣环长度（Ant Ann）、三尖瓣环后半侧瓣环长度（Post Ann）、三尖瓣环周长（Ann）、三尖瓣环二维投影面积（Area）等参数，进行组间对比分析并评价参数与反流量的相关性。结果与E组相比，A组及B组三尖瓣环AP、SM、PostAnn、Ann及Area显著增大（P〈0．05），A组同时伴有SI及AntAnn增大，AP、SM、Post Ann、Ann及Area与反流量呈正相关（P〈0．05）。C组SM、Ant Ann、Post Ann、Ann及Area较E组增大（P〈0．05）。D组与E组差异无统计学意义（P〉0．05）。结论FTR患者在瓣环横径扩张或反流大于中量时均出现瓣环相应三维指标的改变，利用实时三维超声心动图可从形态学上有效提供FTR患者的瓣环信息。Objective To assess the morphological changes of tricuspid annulus in patients with functional tricuspid regurgitation （FTR） by real-time three-dimensional echocardiography. Methods Seventy-five FTR patients were divided into 4 groups according to the tricuspid regurgitation and transverse diameter of tricuspid annulus, which were group A （regurgitation more than moderate and dilated transverse diameter, n = 21）, group B （regurgitation less than moderate and dilated transverse diameter, n = 18）, group C （regurgitation more than moderate and normal transverse diameter, n = 19 ）, group D （regurgitation less than moderate and normal transverse diameter, n = 17）. And 21 healthy controls were chosen to be group E. The 3D parameters including annular anterior-posterior diameter（AP）, annular left- right diameter（SM）, sphericity index （ SI）, non-planar angle （NPA）, anterior annular length （ Ant Ann）, posterior annular length （Post Ann）, annular circumference（Ann） and annular area（Area） were analyzed. Results SM, AP, Post Ann, Ann and Area of group A and B were larger than those in group E, whereas SI and Ant Ann only larger in group A （P〈0.05）. There were positive correlations between SM, AP, Post Ann, Ann, Area and the degree of regurgitation in group A（ P〈0. 05）. The patients of group C showed larger SM, Ant Ann, Post Ann, Ann and Area compared with patients in group E（ P 〈0.05）. There were no significant difference in all 3D parameters between group D and E （ P 〉 0.05）. Conclusions FTR patients with regurgitation more than moderate or dilated transverse diameter are accompanied with changes of 3D annular parameters. The real-time three-dimensional echocardiography is helpful to judge morphological changes of tricuspid annulus in patients with FTR.

关 键 词：超声心动描记术 实时三维 功能性三尖瓣反流 三尖瓣环 

分 类 号：R540.45[医药卫生—心血管疾病]