不同病程肺源性心脏病患者的超声心动图特征及其评估右心功能的价值  

Echocardiographic features of patients with different courses of pulmonary heart disease and their value in evaluating right heart function

作　　者：秦砚戈 姚延丹 张胜龙 Qin Yan-ge;Yao Yan-dan;Zhang Sheng-long(Department of Ultrasound,Henan Third People's Hospital(Henan Occupational Disease Hospital),Zhengzhou 450000,China;Department of Emergency,Henan Provincial People's Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省第三人民医院(河南省职业病医院)超声科,河南郑州450000 [2]河南省人民医院急诊科,河南郑州450000

出　　处：《四川生理科学杂志》2025年第2期338-340,382,共4页

摘　　要：目的:分析不同病程肺源性心脏病(Pulmonary heart disease,PHD)患者的超声心动图特征及其评估右心功能的价值。方法:选取2022年7月~2024年7月间我院及河南省人民医院收治的106例PHD患者作为研究对象,根据病程不同分为缓解期组(n=67)和急性加重期组(n=39)。比较两组患者的超声心动图指标[右心房内径、右心室内径、肺动脉主干内径(Main pulmonary artery diameter,MPAD)、肺动脉平均压(Mean pulmonary artery pressure,MPAP)、肺动脉收缩压(Pulmonary artery systolic pressure,PASP)],右心收缩功能[右心室面积变化分数(Fraction area change,FAC)、右心室心肌做功指数(Right ventricular myocardial performance index,RV-MPI)、三尖瓣环位移(Tricuspid annular plane systolic excursion,TAPSE)],右心室舒张功能[三尖瓣口早期充盈峰值速度(Early diastolic tricuspid inflow velocity,TVE)/舒张晚期峰值速度(Late diastolic tricuspid flow velocity,TVA)、TVE/三尖瓣环舒张早期峰值速度(Peak early diastolic velocity of the tricuspid annulus,TVe′)],并分析上述指标与PHD病程的关系。结果:急性加重期组患者右心房内径、右心室内径、MPAD、MPAP、PASP、RV-MPI显著高于缓解期组(P<0.001),FAC、TAPSE、TVE/TVA、TVE/TVe′显著低于缓解期组(P<0.001)。相关性分析显示,PHD急性加重期与PASP、RV-MPI呈正相关(P<0.05),与TVE/TVA、TVE/TVe′呈负相关,而PHD缓解期则与PASP、RV-MPI呈负相关,与TVE/TVA、TVE/TVe′呈正相关(P<0.05)。结论:不同病程PHD患者的超声心动图特征具有显著差异,且患者右心功能均有不同程度的损伤,应用超声心动图可清楚显示右心功能及形态结构的变化,具有较高的诊断价值。Objective:To analyze echocardiographic features of patients with different courses of pulmonary heart disease(PHD)and their value in evaluating right heart function.Methods:A total of 106 PHD patients admitted to our hospital and Henan Provincial People's Hospital from July 2022 to July 2024 were selected and divided into remission period group and acute exacerbation period group according to the different course of the disease.The two groups were compared on echocardiographic indicators[right atrial diameter,right ventricular diameter,main pulmonary artery diameter(MPAD),mean pulmonary artery pressure(MPAP)and pulmonary artery systolic pressure(PASP)],right ventricular systolic function[fraction area change(FAC),right ventricular myocardial performance index(RV-MPI)and tricuspid annular plane systolic excursion(TAPSE)]and right ventricular diastolic function[early diastolic tricuspid inflow velocity(TVE)/late diastolic tricuspid flow velocity(TVA)and TVE/peak early diastolic velocity of the tricuspid annulus(TVe′)],and the relationship between the above indexes and the course of PHD was analyzed.Results:Compared with remission period group,acute exacerbation period group showed significant increases in right atrial diameter,right ventricular diameter,MPAD,MPAP,PASP and RV-MPI,and significant decreases in FAC,TAPSE,TVE/TVA and TVE/TVe'(P<0.001).Correlation analysis showed that PHD acute exacerbation was positively correlated with PASP and RV-MPI,and negatively correlated with TVE/TVA and TVE/TVe',while PHD remission was negatively correlated with PASP and RV-MPI(P<0.05),and positively correlated with TVE/TVA and TVE/TVe'(P<0.05).Conclusion:There are significant differences in echocardiographic features of patients with different courses of PHD.The patients have varying degrees of right heart damage.Echocardiography can clearly display changes in right heart function and morphological structure,and has high diagnostic value.

关 键 词：不同病程 肺源性心脏病 超声心动图 右心功能 

分 类 号：R540.45[医药卫生—心血管疾病] R541.5[医药卫生—内科学]