Autostrain RV技术联合TDI-Tei指数对肺心病患者右心室收缩功能的评估价值  

The value of Autostrain RV technique combined with TDI-Tei index in evaluating the right ventricular systolic function of patients with pulmonary heart disease

作　　者：王琪 温德惠[2] 李卫天 谢亚宁 刘伟亮[2] 陆海永 WANG Qi;WEN Dehui;LI Weitian;XIE Yaning;LIU Weiliang;LU Haiyong(the First Clinical Medical College,Hebei North University,Zhangjiakou,Hebei 075000,China;Department of Ultrasound Medicine,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000)

机构地区：[1]河北北方学院第一临床医学院,河北张家口075000 [2]河北北方学院附属第一医院超声医学科,河北张家口075000

出　　处：《徐州医科大学学报》2024年第3期214-218,共5页Journal of Xuzhou Medical University

基　　金：河北省卫生健康委科研基金(20211388)。

摘　　要：目的 探讨右心室自动应变定量技术(Autostrain RV)联合组织多普勒(TDI)-Tei指数对慢性肺源性心脏病(CPHD)患者右心室收缩功能的评估价值。方法 根据肺动脉收缩压(PASP)将111例CPHD伴三尖瓣反流患者分为3组:A组(35~49 mmHg, 1 mmHg=0.133 kPa)40例,B组(50~69 mmHg)36例,C组(≥70 mmHg)35例,纳入同期40名健康体检者作为对照组,测量4组常规超声参数及TDI-Tei指数,应用Autostrain RV技术获取右心室整体长轴应变(RV4CSL)、右心室游离壁纵向应变(RVFWSL)、游离壁基底部纵向应变(B-RVFWSL)、中部纵向应变(M-RVFWSL)及心尖部纵向应变(A-RVFWSL)数据,比较各组间差异。结果 与对照组相比,A、B、C组RV4CSL、RVFWSL、B-RVFWSL、M-RVFWSL、A-RVFWSL绝对值及三尖瓣环收缩期平面位移(TAPSE)均减小(P<0.05),且随着PASP升高依次降低,TDI-Tei指数升高(P<0.05),且随着PASP升高依次升高,组间比较差异均有统计学意义(P<0.05)。相关分析显示TDI-Tei指数与RVFWSL相关性较高(r=0.553,P<0.001)。ROC曲线显示Autostrain RV技术、TDI-Tei指数单独及联合评估右心室收缩功能的AUC均大于0.70,联合评估价值更高。结论 Autostrain RV技术能够敏感、准确地评价CPHD患者早期心肌功能障碍,联合TDI-Tei指数可进一步提高评估效能,为临床及时干预提供客观依据。Objective To investigate the value of Autostrain right ventricle(RV)technique combined with tissue doppler imaging(TDI)Tei index in evaluating the right ventricular systolic function of patients with chronic pulmonary heart disease(CPHD).Methods According to pulmonary artery systolic blood pressure(PASP),111 CPHD patients with tricuspid valve regurgitation were divided into three groups:group A(35-49 mmHg,n=40,1 mmHg=0.133 kPa),group B(50-69 mmHg,n=36),and group C(≥70 mmHg,n=35).Meanwhile,40 healthy physical examination subjects were included as a control group.Then,their conventional ultrasonic parameters and TDI-Tei index were measured.The RV global four-chamber longitudinal strain(RV4CSL),the RV longitudinal free wall strain(RVFWSL),longitudinal strain of the base segment of the right ventricular free wall(B-RVFWSL),longitudinal strain of the middle segment of the right ventricular free wall(M-RVFWSL),longitudinal strain of the apical segment of the right ventricular free wall(A-RVFWSL)were obtained by Autostrain RV for comparison of the differences among the groups.Results Compared with the control group,the absolute values of RV4CSL,RVFWSL,B-RVFWSL,M-RVFWSL,ARVFWSL and tricuspid annular plane systolic excursion(TAPSE)in groups A,B and C decreased(P<0.05),along with the increase of PASP.Meanwhile,TDI-Tei index increased(P<0.05),along with the increase of PASP.Statistical differences were found among the groups(P<0.05).According to correlation analysis,TDI-Tei index was highly related to RVFWSL(r=0.553,P<0.001).ROC curve showed that the AUC of Autostrain RV,TDI-Tei index and both in evaluating the right ventricular systolic function were all greater than 0.70,where the combined AUC was higher.Conclusions Autostrain RV can sensitively and accurately evaluate the early myocardial dysfunction of CPHD patients.The combination of Autostrain RV and TDI-Tei index can further improve the evaluation efficiency and provide objective evidence for timely clinical intervention.

关 键 词：Autostrain RV技术 组织多普勒TEI指数 肺源性心脏病 右心室功能 

分 类 号：R445.1[医药卫生—影像医学与核医学]