慢性阻塞性肺疾病肺动脉硬化度与右心室功能的相关性研究  

Correlation Between Pulmonary Artery Stiffness and Right Ventricular Function in Chronic Obstructive Pulmonary Disease

作　　者：王宇萍 薛捷文 潘璐 王琴 Wang Yuping;Xue Jiewen;Pan Lu;Wang Qin(Department of Ultrasound,Sinopharm Tongmei General Hospital,Datong,Shanxi 037036,China;Ultrasound Diagnosis Center,Shaanxi Provincial People’s Hospital,Xi’an 710068,China;Functional Examination Department,Heart Center,Ningxia Medical University General Hospital,Yinchuan 750004,China)

机构地区：[1]国药同煤总医院超声科,山西省大同市037036 [2]陕西省人民医院超声诊断中心,西安市710068 [3]宁夏医科大学总医院心脏中心功能检查部,银川市750004

出　　处：《中国超声医学杂志》2023年第8期875-878,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨慢性阻塞性肺疾病(COPD)的肺动脉硬化度(PAS)与其右心室功能之间的相关性。方法选取就诊的42例COPD患者,同时选取32例健康志愿者作为对照组。测量右心室收缩、舒张和整体功能的常规超声心动图参数、肺动脉最大流速(Pv0)、肺血流加速时间(PAT)、肺血流最大频移(MFS)及PAS。采用Pearson相关分析和多元线性回归分析,分析COPD组PAS与右心室功能参数之间的相关性,并确定PAS与显著相关的参数之间的独立关系。结果COPD组Pv0、MFS及PAS均显著高于对照组,而PAT显著低于对照组(P<0.05)。COPD组平均肺动脉压力(mPAP)、等容舒张时间(IRT)、E/E’及右心室心肌性能指数(RIMP)均显著高于对照组(P<0.05),而COPD组FAC、TAPSE、E’、A’均显著低于对照组(P<0.05)。COPD组PAS与mPAP、E/E′、RIMP呈显著正相关(r=0.821、0.491、0.430,P<0.05);与E’、E’/A’呈显著负相关(r=-0.494、-0.347,P<0.05);且mPAP和E’是PAS的独立预测因素(β=0.728,P=0.000;β=-0.329,P=0.031)。结论COPD患者的PAS升高,与右心室功能参数呈显著相关关系,并且mPAP、E’是PAS的独立预测因素。Objective To explore the correlation between pulmonary artery stiffness(PAS)and right ventricular(RV)function in chronic obstructive pulmonary disease(COPD)patients.Methods A total of 42COPD patients who treated in the were selected,and 32healthy volunteers were selected as the control group.The conventional echocardiographic parameters for right ventricular contraction,relaxation,and global function,maximum velocity of pulmonary artery(Pv0),acceleration time of pulmonary blood flow(PAT),maximum frequency shift of pulmonary blood flow(MFS),and PAS were measured.Pearson correlation analysis and multiple linear regression analysis were used to analyze the correlation between PAS and RV function parameters in the COPD group,and to determine the independent relationship between PAS and significantly related parameters.Results Pv0,MFS and PAS in the COPD group were all significantly higher than those in the control group,while PAT was significantly lower than that in the control group(P<0.05).The mPAP,IRT,E/E′and RIMP in the COPD group were significantly higher than those in the control group(P<0.05),however,FAC,TAPSE,E′and A′in the COPD group were significantly lower than those in the control group(P<0.05).In the COPD group,There were significant positive correlations between PAS and mPAP,E/E′and RIMP in the COPD group,(r=0.821,0.491,0.430,all P<0.05),and significant negative correlation between E′and E′/A′(r=-0.494,-0.347,all P<0.05).mPAP and E′were independent predictors of PAS(β=0.728,P=0.000;β=-0.329,P=0.031).Conclusions The PAS is increased in COPD patients,which is significantly correlated with right ventricular functional parameters,and mPAP,E′are independent predictors of PAS.

关 键 词：肺动脉硬化度 慢性阻塞性肺疾病 右心室功能 超声心动图 

分 类 号：R563.9[医药卫生—呼吸系统]