实时三维超声心动图评价急性肺动脉栓塞患者右心室功能的研究  

Evaluation of right ventricular function in patients with acute pulmonary embolism by real-time three-dimensional echocardiography

作　　者：赖宝春[1,2] 郭薇[1,2] 郑富臻[2,3] 叶振盛[1,2] 林宁[1,2] LAI Bao-chun;GUO wei;ZHENG Fu-zhen;YE Zhen-sheng;LIN Ning(Department of Ultrasonography,Fujian Provincial Hospital,Fuzhou 350001,China;Provincial Clinical Medical College,Fujian Medical University,Fuzhou 350001,China;Department of Cardiovascular Surgery,Fujian Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建省立医院超声科,福州350001 [2]福建医科大学省立临床学院,福州350001 [3]福建省立医院心血管外科,福州350001

出　　处：《创伤与急诊电子杂志》2019年第2期68-73,共6页Journal of Trauma and Emergency(Electronic Version)

基　　金：福建省卫生厅创新课题(2011-CX-2);福建省卫计委青年基金课题(2018-2-1)

摘　　要：目的应用实时三维超声技术(real-time three-dimensional echocardiography,RT-3DE)检测急性肺动脉栓塞(pulmonary embolism,PE)患者右心功能,评价其临床应用价值。方法选取2016年1月至2019年1月本院住院的肺动脉栓塞患者,共30例,作为病例组;对照组为30例健康志愿者。应用GE-E95彩色多普勒超声诊断仪对患者进行检查,常规的测量指标有:主肺动脉内径(main pulmonary artery diameter,MPA)、右房横径(right atrial transverse diameter,RAD)、右室横径(right ventricular transverse diameter,RVD)、肺动脉收缩压(pulmonary arterial systolic pressure,PASP),右室面积变化率(right ventricular area change rate,RVFCA)。三维超声测量指标有:右室收缩末期容积(right ventricular end-systolic volume,RVESV),右室舒张末期容积(right ventricular end-diastolic volume,RVEDV),右室射血分数(right ventricular ejection fraction,RVEF),右室每搏输出量(right ventricular stroke output,RVSV)。结果病例组与对照组的MPA、RAD、RVD、RVFAC等指标无明显差异(P>0.05),病例组的PASP明显高于对照组[(35.35±3.68)mmHg v.s.(23.78±2.97)mmHg](P<0.05)。与对照组相比,病例组的RVEDV明显升高[(79.63±4.63)ml v.s(75.40±8.67)ml)](P<0.05)、RVESV明显升高[(43.26±3.64)ml v.s(39.66±6.61)ml)](P<0.05),RVEF明显降低[(42.23±4.36)%v.s(45.38.±4.21)%)](P<0.05)、RVSV明显降低[(31.23±3.51)ml v.s(34.20±7.01)ml](P<0.05)。结论实时三维超声可以较常规超声技术更早发现肺动脉栓塞患者的右心功能不全,是右心功能评价的有效工具。Objective To evaluate the right ventricular function in patients with acute pulmonary embolism by real-time three-dimensional echocardiography(RT-3DE).Methods Thirty cases of patients with pulmonary embolism who were admitted to our hospital from January 2016 to January 2019 were allocated into the case group.Thirty healthy volunteers were allocated into the control group.GE-E95 color doppler ultrasound diagnostic instrument was used to measure the main pulmonary artery diameter(MPA),right atrial transverse diameter(RAD),right ventricular transverse diameter(RVD),pulmonary artery systolic pressure(PASP),and right ventricular area change rate(RVFCA).Indicators of the right ventricular function measured by three-dimensional ultrasound include right ventricular end-systolic volume (RVESV),right ventricular end-diastolic volume (RVEDV), right ventricular ejection fraction (RVEF) andright ventricular stroke output (RVSV). Results There was no significant difference in MPA,RAD, RVD, RVFAC between the case group and the control group (P>0.05), and the PASP ofthe case group was significantly higher than that of the control group[(35.35±3.68) mmHg v.s.(23.78±2.97) mmHg, (P<0.05)]. Compared with the control group, RVEDV was significantlyincreased in the case group [(79.63±4.63) ml v.s. (75.40±8.67) ml, (P<0.05)]. RVESV was alsosignificantly increased in the case group[(43.26±3.64) ml v.s. (39.66±6.61) ml, (P<0.05)]. RVEFwas significantly decreased significantly in the case group [(42.23±4.36)% v.s. (45.38.±4.21)%,(P<0.05)]. So was the RVSV[(31.23±3.51) ml v.s. (34.20±7.01) ml, (P<0.05)]. ConclusionReal-time three-dimensional ultrasound can make an earlier detection on right heart dysfunctionin patients with pulmonary embolism than conventional ultrasound technology, and it is aneffective option for right heart function evaluation.

关 键 词：实时三维超声心动图 肺动脉栓塞 右心室功能 射血分数 

分 类 号：R54[医药卫生—心血管疾病]