心肌做功技术评估肺动脉瓣反流患者右心室功能的研究  

Assessment of Myocardial Work Technology on Right Ventricular Function in Patients with Pulmonary Regurgitation

作　　者：翁子墨 冯德喜 WENG Zimo;FENG Dexi(Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014000 China;Inner Mongolia Autonomous Region People's Hospital,Hohhot 010017 China)

机构地区：[1]内蒙古科技大学包头医学院,内蒙古包头014000 [2]内蒙古自治区人民医院,呼和浩特010017

出　　处：《内蒙古医学杂志》2024年第8期953-957,共5页Inner Mongolia Medical Journal

基　　金：2022年度内蒙古自治区卫生健康科技计划项目(编号:202201019)。

摘　　要：目的探讨超声心肌做功技术评价不同程度肺动脉瓣反流(PR)患者右心室收缩功能的临床价值。方法将2022年10月至2023年10月就诊于内蒙古自治区人民医院的轻中度PR患者、重度PR患者各50例及体检健康者50例纳入研究,分析临床资料,常规超声参数,右心室心肌做功参数包括整体做功指数、整体有效功、整体做功效率和整体无效功。结果(1)3组患者除肺动脉内径、肺动脉瓣反流PHT值以外,一般临床资料差异均无统计学意义(P>0.05)。(2)与正常对照组、PR轻中度组比较,PR重度组右室壁厚度增厚,RV-d/LV-d增高,TAPSE、FAC、S’及RVGLS均减低,差异有统计学意义(P<0.01);与正常对照组比较,PR轻中度组FAC、RVGLS减低,差异有统计学意义(P<0.01)。(3)随着PR程度增加,RVGWI、RVGCW、RVGWW均逐渐增高,RVGWE逐渐减低,各组比较差异均有统计学意义(均P<0.01)。(4)相关性分析显示,RVGWI、RVGCW和RVGWW与PA内径呈正相关,与FAC、TAPSE、S’、RVGLS呈负相关;RVGWE与PA内径呈负相关,与FAC、TAPSE、S’、RVGLS呈正相关。结论心肌做功参数可以准确检测不同程度PR患者的右心功能损伤程度,对轻中度、重度PR均有诊断价值。Objective:To investigate the clinical value of ultrasonic myocardial work technology in evaluating the right ventricular systolic function of patients with pulmonary regurgitation(PR)of varying degrees.Methods To collected from October 2022 to October 2023 at the Inner Mongolia Autonomous Region People's Hospital,including 50 patients with mild to moderate PR,50 patients with severe PR,and 50 healthy individuals as a control group,to be included in the study.Clinical data,conventional ultrasound parameters,and right ventricular myocardial work parameters,including global work index,global constructive work,global work efficiency,and global wasted work,were analyzed.Results(1)Except for the diameter of the pulmonary artery and the PHT value of pulmonary regurgitation,there was no statistical significance in general clinical data among the three groups(P>0.05).(2)Compared with the normal control group and the mild to moderate PR group,the severe PR group showed increased thickness of the right ventricular wall,elevated RV-d/LV-d ratio,and decreased TAPSE,FAC,S',and RVGLS,with statistically significant differences(P<0.01).Compared with the normal control group,the mild to moderate PR group showed reduced FAC and RVGLS,with statistically significant differences(P<0.01).(3)As the degree of PR increased,RVGWI,RVGCW and RVGWW gradually increased,while RVGWE gradually decreased,with statistically significant differences among the groups.(4)Correlation analysis showed that RVGWI,RVGCW and RVGWW were positively correlated with the diameter of the PA,and negatively correlated with FAC,TAPSE,S'and RVGLS;RVGWE was negatively correlated with the diameter of the PA,and positively correlated with FAC,TAPSE,S'and RVGLS.Conclusion Myocardial work parameters can accurately detect right ventricular functional impairment in patients with PR of varying degrees,providing diagnostic value for both mild to moderate and severe PR.

关 键 词：心肌做功 压力-应变环 肺动脉瓣反流 右室重构 

分 类 号：R541[医药卫生—心血管疾病]