摘要
目的应用超声心动图测量右心系统一系列常规参数与右心导管测值对比,为临床提供简单可靠重复性良好的测量肺动脉高压的方法。方法选择临床确诊肺动脉高压(pulmonary arterial hypertension,PAH)患者82例(PAH组),正常对照组86例,将所有研究对象的常规超声心动图参数进行对比,并对超声心动图参数与右心导管测值进行相关性研究。结果 PAH组舒张末期右心室前后径、舒张末期右心室左右径、收缩期右心房上下径、收缩期右心房左右径、右心房容积、下腔静脉内径、三尖瓣反流压差(tricuspid regurgitation pressure gradient,TRPG)均高于正常对照组(P<0.01),PAH组的下腔静脉塌陷指数(collapsible index of inferior vena cava,IVCCI)、收缩期s波速度峰值(systolic peak velocity,s′)、舒张早期e波速度峰值(early diastolic peak velocity,e′)、舒张晚期a波速度峰值(late diastolic peak velocity,a′)、收缩期三尖瓣瓣环平面位移(tricuspid annular plane systolic excursion,TAPSE)、右心室射血前期(previous ejection period,PEP)/右心室射血期(ejection time,ET)均低于正常对照组(P<0.01)。PAH组82例临床确诊的PAH患者中58例行右心导管测值,TRPG、IVCCI与右心导管测得肺动脉收缩压呈正相关(r=0.961、0.669,P<0.01)。TAPSE、s′与右心导管测得肺动脉收缩压呈负相关(r=-0.629、-0.772,P<0.01)。结论收缩期TAPSE、IVCCI、TRPG、组织多普勒三尖瓣瓣环运动频谱s波与右心导管测值相关性良好,综合以上几个参数可以提高超声心动图诊断PAH的准确性。
Objective To provide a simple,reliable method of good repeatability for measuring pulmonary arterial hypertension（PAH） by comparing a series of general echocardiographic parameters of right heart with right heart catheterization for the clinic.Methods Eighty-two patients in PAH group diagnosed by clinic and 86 normal persons in control group were enrolled for study.All the general echocardiographic parameters between two groups were compared,and the correlation of the echocardiographic parameters with right heart catheterization were analyzed.Results The right ventricular anterior-posterior diameter（RV A-PD）,right ventricular left-right diameter（RV L-RD,right atrium superior-inferior diameter（RA S-ID）,right atrium left-right diameter（RA L-RD）,right atrium volume（RAV）,inferior vena cava diameter（IVCD）,tricuspid regurgitation pressure gradient（TRPG）of PAH group were statistically higher than those of control group（P〈0.01）,collapsible index of inferior vena cava（IVCCI）,systolic peak velocity（s′）,early diastolic peak velocity（e′）,late diastolic peak velocity（a′）,tricuspid annular plane systolic excursion（TAPSE）,previous ejection period/ejection time,PEP/ET of PAH group were statistically lower than those of control group（P〈0.01）.Fifty-eight patients in PAH group were detected by right heart catheterization.TRPG and IVCCI were positively associated with the pulmonary artery systolic pressure（r=0.961,0.669,P〈0.01）,TAPSE,s′were negative correlation with the pulmonary artery systolic pressure（r=-0.629,-0.772,P〈0.01）.Conclusion TAPSE,IVCCI,TRPG and s′correlated well with right heart catheterization,showing high measurement accuracy and reproducibility.Echocardiographic parameters can improve the diagnostic accuracy of pulmonary hypertension by echocardiography.
出处
《河北医科大学学报》
CAS
2015年第5期547-550,共4页
Journal of Hebei Medical University
