肺动脉收缩压超声心动图估测结果校正方法研究  

Research on the correction method of pulmonary systolic pressure estimation by echocardiography

作　　者：徐黎莎[1] 毕珂 张怡 王茵 Xu Lisha;Bi Ke;Zhang Yi;Wang Yin(Department of Uhrasonography,Shanghai Pulmonary Hospital,Tongji University,Shanghai 200433,China)

机构地区：[1]同济大学附属上海市肺科医院超声科,上海200433

出　　处：《中华航海医学与高气压医学杂志》2018年第3期169-172,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探讨超声心动图对肺动脉收缩压（pulmonary artery systolic pressure, PASP）估测结果的校正方法，使其估值更接近于金标准。方法连续选取肺动脉高压患者120例，按时间顺序平均分为回顾组与前瞻组，回顾组采用三尖瓣反流压差＋估测右房压的方法估测PASP，并计算其与右心导管测压的差值，以差值为依据，将患者分为5个小组，分别取各小组差值平均数的整数部分作为校正常数。再测量右心房左右径、右心室舒张末期左右径、三尖瓣环收缩期位移、三尖瓣环收缩期S波峰值、主肺动脉内径，分别在各小组间对以上参数进行t检验，选取明显差异指标作为前瞻组分组标准。前瞻组以该标准分为5个小组，并将各组校正常数与传统肺动脉收缩压估测值相加得到校正结果，再将传统估测结果与校正结果比较，评价校正方法的可行性。结果由回顾组得到校正常数分别为28、14、0、－15、－29，前瞻组的分组标准为：B1（≤1.65 cm）、B2（1.65～1.75 cm）、B3（1.75～1.81 cm）、B4（1.81～1.89 cm）、B5（〉1.89 cm）。前瞻组结果经校正后准确率显著升高。结论本研究提出的校正方法显著提高了肺动脉收缩压估测值的准确性，方法简单，具有临床推广价值。ObjectiveTo investigate the correction method for estimating pulmonary artery systolic pressure （PASP） by echocardiography （Echo） and make the valuation closer to the gold standards.MethodsOne hundred and twenty cases of pulmonary arterial hypertension were selected in a row for the study and were equally divided into 2 groups： the retrospective group and the prospective group in accordance with the sequence of time. In the retrospective group, PASP was estimated by using tricuspid regurgitant pressure gradient ＋ estimation of right arterial pressure, and the difference between PASP and the value of right heart catheterization was calculated. In accordance with the said difference, the patients were divided into 5 subgroups and the integral part of the average of each group was taken as a correction constant. Then, right atrium transverse diameter, right ventricle transverse diameters, main pulmonary artery diameter, tricuspid annular plane systolic excursion, systolic peak velocity and main pulmonary artery6 diameter measured by echocardiography were analyzed by t test, and the significant different indicator was chosen as the division standards for the prospective group, which was also divided into 5 subgroups with this division standards. Calibration results were thus obtained by corrected constants of each group added with the estimation value of conventional pulmonary arterial systolic pressure. Finally, the traditional estimation results were compared with the correction results, and the feasibility of the correction method was evaluated.ResultsThe correction constants calculated in the prospective group were 28, 14, 0, -15 and -29. The division standard of the prospective group were： B1（TAPSE≤1.65 cm）, B2（1.65 cm〈TAPSE≤1.75 cm）, B3（1.75 cm〈TAPSE≤1.81 cm）, B4（1.81 cm〈TAPSE≤1.89 cm） and B5（TAPSE〉1.89 cm）. The accuracy of prospective group was significantly increased after correction.ConclusionsThe correction method proposed in this study significantly improve

关 键 词：超声心动图 右心导管 肺动脉高压 数据校正 

分 类 号：R823[医药卫生—临床医学]