实时三维超声心动图定量评估肝硬化患者右心房容积功能特征  

Quantitative Assessment of Right Atrial Volume Function in Patients with Cirrhosis by Real-time Three-dimensional Echocardiography

作　　者：汤飞云 冯泽阳 叶香华 TANG Fei-yun;FENG Ze-yang;YE Xiang-hua(The Department of Ultrasonography, Tongde Hospital of Zhejiang Province, Zhejiang 310012, China)

机构地区：[1]浙江省立同德医院超声科,310012 [2]浙江大学附属第一医院放疗科,310006

出　　处：《心脑血管病防治》2018年第6期461-464,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

基　　金：浙江省科技厅项目(编号:2015C33199)

摘　　要：目的运用实时三维超声心动图定量评估肝硬化患者右心房容积功能变化特征,探讨其与Child-Pugh肝功能分级的相关性。方法选取经临床确诊的94例肝硬化患者作为研究对象,根据Child-Pugh肝功能分级划分为:A组(肝功能A级,35例)、B组(肝功能B级,31例),C组(肝功能C级,28例),同期选择35例健康体检者作为对照组。所有研究对象均接受实时三维超声心动图检查,测量并计算右心房各时相容积参数,包括总排空容积指数(EVIt)、被动排空容积指数(EVI-p)和主动排空容积指数(EVI-a)。结果 A组患者的EVI-t、EVI-a较对照组增大,而EVIp较对照组下降(均P <0. 05); B组患者的EVI-t、EVI-a、EVI-p均较A组下降(均P <0. 05); C组患者的EVI-t、EVI-a、EVI-p均较B组下降(均P <0. 05);肝硬化患者EVI-t、EVI-a、EVI-p分别与Child-Pugh肝功能分级呈负相关(r=-0. 68,-0. 64,-0. 74,均P <0. 05)。结论实时三维超声心动图能准确监测不同Child-Pugh肝功能分级肝硬化患者右心房各时相容积功能状态,可为临床评估肝硬化患者右心功能提供有价值的参考。Objective To evaluate the characteristics of right atrial volume fun ction in patients with cirrhosis by real-time three-dimensional echocardiography(RT-3DE),and the correlation with Child-Pugh scores.Methods94patients with cirrhosis diagnosed in our hospital were selected.According to Child-Pugh sco r es,they were divided into group A(liver function grade A,35cases),group B(liver function grade B,31cases)and group C(liver function grade C,28cases).35healthy persons were included simultaneously as the control group.All su bj ects received RT-3DE,the volume parameters of the right atrium including total emptying volume index(EVI-t),passive emptying volume index(EVI-p)and active emptying volume index(EVI-a)were measured and calculated.Results The EVI-t an d EVI-a in the group A were higher than those in the control group,while the EV I-p was lower than that in the control group(all P<0.05).The EVI-t,EVI-a and EVI-p in group B were lower than those in group A(all P<0.05).The EVI-t,EVI-a and EVI-p in group C were lower than those in group B(all P<0.05).The EVI-t,EVI-a and EVI-p in patients with cirrhosis were negatively co rrelated with Child-Pugh scores(r=-0.679,-0.641,-0.738,all P<0.05).Conclusions RT-3DE can accu rately monitor the right atrial volume function in patients with cirrhosis with different Child-Pugh scores,and provide valuable reference for the clinical eva luation of right cardiac function in patients with cirrhosis.

关 键 词：实时三维超声心动图 肝硬化 CHILD-PUGH肝功能分级 右心房功能 

分 类 号：R540.45[医药卫生—心血管疾病]