超声心动图参数对肺动脉栓塞溶栓治疗的预后价值  

The Prognostic Value of Echocardiographic Parameters in Thrombolysis for Pulmonary Embolism

作　　者：刘贵凤 黄云洲[2] 任书堂[2] 李冬蓓[2] 龙进[2] 王翠华[2] LIU Gui-feng;HUANG Yun-zhou;REN Shu-tang;LI Dong-bei;LONG Jin;WANG Cui-hua(Chengde Medical College,Chengde Hebei 067000;Ultrasound department of Taida International Cardiovascular Disease Hospital,Tianjin 300457)

机构地区：[1]承德医学院,河北承德067000 [2]泰达国际心血管病医院超声科,天津300457

出　　处：《世界最新医学信息文摘》2018年第18期15-17,23,共4页World Latest Medicine Information Electronic Version

摘　　要：目的评价经胸超声心动图(Transthoracic echocardiography,TTE)的多个参数对肺动脉栓塞(pulmonary embolism,PAE)溶栓治疗效果的预后价值。方法经CT或核素肺灌注证实为PAE的肺动脉栓塞患者59例,根据治疗前后肺动脉收缩压(Pulmonary arterial systolic pressure,PASP)下降程度,将其分为溶栓有效组和溶栓无效组;经CT或核素肺灌注排除PAE但存在肺动脉高压(pulmonary hypertension,PH)患者36例即PH组,通过定性和定量分析比较各组超声参数之间的差别,对差别最显著的超声参数进行多种组合的诊断性试验。结果在定量分析中,通过与溶栓有效组进行比较,溶栓无效+PH组中的参数二尖瓣e峰流速(Vemv)、肺动脉瓣正向流速峰值(Vp-pv)均有显著性差别(P<0.001)。在定性分析中,溶栓有效组与溶栓无效+PH组进行比较,三尖瓣反流(tricuspid regurgitation,TR)程度具有显著性差别(P<0.001)。将参数Ve-mv、Vp-pv和TR程度进行多种组合的诊断性试验,当Ve-mv或Vp-pv以1.0m/s为界限值、TR程度以中量为界限值时诊断效率最高。结论当Ve-mv与Vp-pv及TR程度联合应用时,可对PAE患者的溶栓效果进行一定程度的预后判断。Objective To evaluate the prognostic value of echocardiographic parameters in determining the effect of thrombolysis for pulmonary embolism(pulmonary embolism,PAE).Methods According to the decreased degree of the pulmonary artery systolic pressure(PASP)after thrombolysis,59 patients with pulmonary embolism,diagnosed using CT or radionuclide pulmonary perfusion,were divided into effective group or ineffective group.And 36 patients with pulmonary hypertension without PAE were regard as the PH group using the same methods.The ultrasonic parameters of each group were compared by qualitative and quantitative statistical analysis and diagnostic tests on the most significant ultrasonic parameters carried out.Result Comparing with the effective group,the Ve-mv(E peak flow velocity of mitral valve)and Vp-pv(peak flow velocity of pulmonary valve)of the ineffective and PH group were different significantly(both P<0.001)on the quantitative analysis.While the degree of TR(tricuspid regurgitation,TR)of the ineffective and PH group were different significantly(P<0.001)on the qualitative analysis.In combination with the above three parameters,we found that the diagnostic efficiency is the highest when Ve-mv or Vp-pv was 1.0m/s and TR was moderate as the boundary value.Conclusions Combination of the Ve-mv,Vp-pv and TR of TTE,has the prognostic value at some extent in evaluating the effect of thrombolysis for PAE.

关 键 词：超声心动图 肺动脉栓塞 溶栓 

分 类 号：R542.54[医药卫生—心血管疾病]