血吸虫病相关性肺高血压的超声心动图研究  

Echocardiographic Study on Schistosomiasis Associated Pulmonary Hypertension

作　　者：胡敏[1] 方卫东[2] 魏言芳 杨红 陈晨 张佑成 Hu Min;Fang Weidong;Wei Yanfang;Yang Hong;Chen Chen;Zhang Youcheng(Department of Echocardiogram and Electrocardiogram,Huangshan City People's Hospital,Huangshan,Anhui 245000,China;Department of Infection,Huangshan City People's Hospital,Huangshan,Anhui 245000,China)

机构地区：[1]黄山市人民医院心电功能检查科,安徽省黄山市245000 [2]黄山市人民医院感染科,安徽省黄山市245000

出　　处：《中国超声医学杂志》2024年第5期591-594,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的研究血吸虫病相关性肺高血压的超声心动图特征。方法从超声心动图肺高血压高度可能的前瞻性研究队列中筛选肝脾型血吸虫病患者10例为观察组,其他病因性肝病12例为对照组,分析超声心动图特征。结果与对照组比较,观察组有较高的年龄[84(81~88)岁(P=0.029)];心力衰竭、心房颤动、慢性肾衰竭发病率较高(P<0.05);左心疾病、慢性肺病、肝硬化、门脉高压发病率差异无统计学意义(P>0.05);房室内径较小,但仅右心室长径和基底径差异有统计学意义(P<0.05);三尖瓣反流峰速[3.9(3.4~4.5)m/s]和肺血管阻力[2.5(2.3~3.4)]WU(Wood单位)差异无统计学意义(P>0.05);右心功能不全检出率(50.0%)较高(P=0.005)。Kaplan-Meier生存分析发现右心功能不全显著缩短心力衰竭再入院时间(χ^(2)=8.323,P=0.004)。结论血吸虫病相关性肺高血压心脏形态和功能类似限制型心肌病样改变,因右心力衰竭再入院率高。Objective To study the echocardiographic characteristics of schistosomiasis associated pulmonary hypertension(Sch-PH).Methods From a prospective cohort study of high echocardiographic probability of pulmonary hypertension,10 patients with advanced hepatosplenic schistosomiasis were selected as the observation group,and 12 cases of other etiological liver diseases were selected as the control group,in order to analyze the echocardiographic characteristics of Sch-PH.Results Compared with the control group,the observation group had a higher age of 84(81-88)years(P=0.029);and the incidences of heart failure,atrial fibrillation and end-stage kidney disease were higher(P<0.05);the differences of the incidences of left heart disease,chronic lung disease,cirrhosis and portal hypertension were not significant(P>0.05);all of the cardiac diameters was smaller,but only the differences of right ventricular longitudinal and basal diameters were statistically significant(P<0.05);the differences of peak velocity of tricuspid regurgitation of 3.9(3.4-4.5)m/s and pulmonary vascular resistance of 2.5(2.3-3.4)WU(Wood unit)were not significant(P>0.05);the detection rate of right heart dysfunction(50.0%)was significantly higher(P=0.005).Kaplan-Meier survival analysis showed that right heart dysfunction significantly shortened the time of readmission for heart failure in all patients(χ^(2)=8.323,P=0.004).Conclusions Sch-PH is similar to restrictive cardiomyopathy in cardiac morphology and function which has a high readmission rate due to right heart failure.

关 键 词：日本血吸虫病 肺高血压 超声心动图 预后 

分 类 号：R54[医药卫生—心血管疾病]