应用实时三维超声心动图评估COPD患者的右心室功能  

Assessment of right ventricular function by real-time three-dimensional echocardiography in chronic obstructive pulmonary disease patients

作　　者：谭静[1] 梁勤[1] 罗依然[1] 杨阳 冯珂 TAN Jing;LIANG Qin;LUO Yiran;YANG Yang;FENG Ke(Cardiology Department,Guizhou Provincial People’s Hospital,Cardiovascular Disease Research Centre of Guizhou Province,Guiyang 550002,China)

机构地区：[1]贵州省人民医院心内科·贵州省心血管疾病研究所,贵州贵阳550002

出　　处：《西部医学》2022年第12期1851-1855,共5页Medical Journal of West China

基　　金：贵州省人民医院青年基金(GZYQN2018[02]);黔科合平台人才([2017]5405)。

摘　　要：目的探讨实时三维超声心动图(RT-3DE)对慢性阻塞性肺病(COPD)患者右心室收缩及舒张功能改变的评估。方法选取2019年9月~2021年3月于我院住院的60例COPD患者作为受试者,按照GOLD分级分为两组,GOLDⅠ级和Ⅱ级患者为COPD 1组,Ⅲ级和Ⅳ级患者为COPD 2组,同时匹配来我院体检的相同年龄段的健康志愿者40例作为对照组。采集超声心动图图像并应用RT-3DE的4DRVQ软件测量右心室收缩和舒张功能参数,收集mMRC评分。结果COPD 1组的RVEDV、RVESV、RVEF、TAPSE、FAC%、TVE/TVA、TVE/TVe与对照组比较差异均无统计学意义(P>0.05),而FEV1、FEV1占预计值百分比(FEV1%)低于对照组(P<0.01),mMRC评分,肺动脉收缩压(PAP)高于对照组(P<0.01)。与COPD 1组比较,COPD 2组FEV1、FEV1%、TAPSE、FAC%、TVE/TVA、RVSV、RVEF降低,mMRC评分、PAPTVE/TVe、RVEDV、RVESV增加(P<0.01)。结论RT-3DE可准确评估COPD患者的右心室功能;GOLDⅠ、Ⅱ级的COPD患者右心大小无明显变化、收缩及舒张功能受损不显著,Ⅲ、Ⅳ级的COPD患者的右心增大,收缩及舒张功能均受损。Objective To investigate the changes in right ventricular systolic and diastolic function in patients with COPD using 4DRVQ software by RT-3DE.Methods 60 COPD patients from September 2019 to March 2021 were selected as subjects,divided into two groups according to GOLD grade,GOLD gradesⅠ,Ⅱdivided as group COPD 1,GOLD gradesⅢ,Ⅳdivided as group COPD 2,and 40 healthy volunteers of the similar age as the control group.RT-3DE images were collected and right ventricular systolic and diastolic function parameters were measured using 4DRVQ software,mMRC scores were also collected.Results RVEDV,RVESV,RVEF,TAPSE,FAC%,TVE/TVA,TVE/TVe in COPD group 1 showed no significant difference from the control group(P>0.05),while in COPD group 2,FEV1,FEV1%were lower(P<0.01),mMRC scores and pulmonary artery systolic blood pressure(PAP)were higher than the control group(P<0.01).The mMRC scores,PAP,RVEDV,RVESV were higher(P<0.01),RVSV RVEF,TAPSE,FAC%,TVE/TVA were lower,and TVE/Tve were higher compared with the COPD group 2(P<0.01).Conclusion RT-3DE can accurately assess RV function in COPD patients.The RV volume,systolic and diastolic function of COPD patients with GOLD gradesⅠandⅡwere not significantly changed but significantly impaired in COPD patients with GOLD gradesⅢandⅣ.

关 键 词：慢性阻塞性肺病 超声心动描记术 右心室功能 实时三维 4DRVQ 

分 类 号：R563[医药卫生—呼吸系统]