四维右室容积定量分析技术评估原发性高血压病患者右室收缩功能  

Value of 4D-RV-Volume in the assessment of right ventricular systolic function in patients with essential hypertension

作　　者：陈烨 苏晖 张皓东 张建华 CHEN Ye;SU Hui;ZHANG Haodong;ZHANG Jianhua(Department of Ultrasound,Southern University of Science and Technology Hospital,Shenzhen 518000,China)

机构地区：[1]南方科技大学医院超声科,深圳市518000

出　　处：《临床超声医学杂志》2020年第6期420-424,共5页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨四维右室容积定量分析(4D-RV-Volume)技术评估原发性高血压病患者右室收缩功能的临床价值。方法选择84例原发性高血压病患者,按照左室质量指数(LVMI)不同分为正常LVMI组44例和高LVMI组40例;另选同期健康体检者45例为对照组;记录各组二维超声参数即左室舒张末期内径(LVIDD)、左室收缩末期内径(LVESD)、左室后壁厚度(LVPWT)、室间隔厚度(IVST)、左室射血分数(LVEF)、三尖瓣环收缩期位移(TAPSE)、三尖瓣舒张早晚期峰值速度比值(E/A)、肺动脉收缩压(PASP)及右室Tei指数;4D-RV-Volume技术获取右室舒张末期容积(RVEDV)、右室收缩末期容积(RVESV)、右室射血分数(RVEF)、右室游离壁纵向应变率(RVFLS)、室间隔纵向应变率(RVSLS)、面积变化分数(RVFAC)等;比较各组上述参数变化。结果高LVMI组LVIDD、LVESD、LVPWT、IVST、RVEDV、RVESV均高于对照组,LVEF低于对照组,差异均有统计学意义(均P<0.05);高LVMI组TAPSE高于对照组和正常LVMI组,RVSLS低于正常组和对照组,差异均有统计学意义(均P<0.05);对照组、正常LVMI组、高LVMI组E/A、RVFLS、RVFAC、RVEF均呈降低趋势,PASP、右室Tei指数均呈升高趋势,组间两两比较差异均有统计学意义(均P<0.05)。RVEF与右室Tei指数、PASP均呈负相关(r=-0.513、-0.470,均P<0.05),与TAPSE呈正相关(r=0.607,P<0.05)。4D-RVVolume技术检测右室RVEDV、RVESV、RVEF在不同观察者间具有良好的一致性。结论4D-RV-Volume技术可定量分析原发性高血压病患者右室结构和功能。Objective To investigate the clinical application value of 4D-RV-Volume in the assessment of right ventricular systolic function in patients with essential hypertension.Methods Eighty-four patients with essential hypertension were divided into normal left ventricular mass index(LVMI)group(44 cases)and high LVMI group(40 cases),45 health examiner were chosen as the control group.Left ventricular end diastolic diameter(LVIDD),left ventricular end systolic diameter(LVESD),left ventricular posterior wall thickness(LVPWT),interventricular septal thickness(IVST),left ventricular ejection fraction(LVEF),tricuspid annulus systolic displacement(TAPSE),ratio of early to late peak velocity(E/A),pulmonary artery systolic pressure(PASP)and right ventricular Tei index were recorded.4D-RV-Volume technique was used to obtain the parameters of right ventricular end diastolic volume(RVEDV),right ventricular end systolic volume(RVESV),right ventricular ejection fraction(RVEF),right ventricular free wall longitudinal strain rate(RVFLS),interventricular septal longitudinal strain rate(RVSLS),area change fraction(RVFAC).The results were compared in groups.Results LVIDD,LVESD,LVPWT,IVST,RVEDV,RVESV of the high LVMI group were higher than those of the control group(all P<0.05),LVEF was lower than that of the control group(P<0.05),TAPSE of the high LVMI group was higher than that of the control group and the normal LVMI group(both P<0.05),E/A,RVFLS,RVFAC,and RVEF of the control group,the normal LVMI group and the high LVMI group were all decreased(all P<0.05),PASP and Tei index were increased(all P<0.05).RVSLS was lower than that of the normal group and the control group(both P<0.05).RVEF was negatively correlated with Tei index and PASP(r=-0.513,-0.470,both P<0.05),and positively correlated with TAPSE(r=0.607,P<0.05).RVEDV,RVESV,and RVEF of right ventricle showed good consistency by 4D-RV-Volume technique.Conclusion 4D-RV-Volume technique can be used to quantitatively analyze the structure and function of right ventricle in patients wit

关 键 词：超声心动描记术 四维右室容积定量分析 高血压病 原发性 心室功能 右 

分 类 号：R540.4[医药卫生—心血管疾病] R544.1[医药卫生—内科学]