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组织多普勒室壁运动时间对肺动脉高压患者右室功能的评价

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2013年第5期
页码:
547-550557
栏目:
临床研究
出版日期:
2013-09-25

文章信息/Info

Title:
Assessment of right ventricular function in patients with pulmonary hypertension using tissue Doppler imaging time intervals
作者:
薛明华1; 张 琴2; 侯代伦1; 王 星2; 王 磌2; 隋树建3
(1.山东省胸科医院超声科，山东 济南 250013；2.山东省交通医院超声科，山东 济南 250031；3.山东大学第二医院心内科，山东 济南 250033)
Author(s):
XUE Ming hua1;  ZHANG Qin2;  HOU Dai lun1;  WANG Xing2;  WANG Tian2;  SUI Shu jian3
(1.Department of Medical Ultrasound, Shandong Chest Hospital, Jinan 250013, Shandong, China; 2.Department of Medical Ultrasound, Shandong Traffic Hospital, Jinan 250031, Shandong, China; 3.Department of Cardiology, Second Hospital, Shandong University, Jinan 250033, Shandong, China)
关键词:
组织多普勒成像; 肺动脉高压; 时间间期; 心室功能
Keywords:
tissue Doppler imaging;  pulmonary hypertension;  time interval;  ventricular function
分类号:
R543.2;R730.41
DOI:
-
文献标识码:
A
摘要:
目的:利用脉冲组织多普勒技术（PW-TDI）测量右室室壁运动时间间期评价肺动脉高压（PH）患者右心功能的变化。方法： PH患者150例，根据PH的程度分为轻度组、中度组、重度组，每组50例，应用PW-TDI测量心尖四腔心切面三尖瓣前瓣瓣环心肌运动的时间间期指标包括：电-机械时间（EMD）、射血前期(PEP)、等容收缩时间(ICT)、心室射血时间(ET)、等容舒张时间(IRT)、充盈时间（FT），计算Tei指数。将PH组与正常对照组的心肌运动时间间期参数进行比较，通过统计分析了解不同程度PH患者右心功能变化。结果： 与正常对照组比较，轻度组IRT延长（P<0.01）；中度组IRT延长、FT缩短（均P<0.01）；重度组IRT、ICT和PEP延长、ET和FT缩短（均P<0.01）。Tei指数在PH组均增大（均P<0.01）。中度组较轻度组、重度组较轻度组、重度组较中度组IRT延长、FT缩短（均P<0.05）；重度组较轻度组ICT和PEP延长、ET缩短、Tei指数增大（均P<0.05）。EMD在不同水平PH组和正常对照组间无显著性差异。 结论：PH导致右室收缩和舒张功能降低，舒张功能降低早于收缩功能降低。
Abstract:
AIM:To explore the changes of right ventricular function in patients with pulmonary hypertension (PH) using time intervals of right ventricular motion from pulsedwave tissue Doppler imaging (PWTDI). METHODS: One hundred and fifty PH patients and 60 agematched controls were studied. Patients were divided into three PH groups according to their PH level. PWTDI was used to record the anterior tricuspid annulus motion in the apical fourchamber view. Parameters of time intervals including electromechanical delay (EMD), isovolumetric contraction time (ICT), preejection period (PEP), ejection time (ET), isovolumetric relaxation time (IRT) and filling time (FT) were measured and Tei index was calculated. Data were analyzed with statistical software. RESULTS: Compared with control group, IRT in mild PH group was prolonged (P<001), and IRT was prolonged and FT shortened in moderate PH group (P<001). In severe PH group, IRT, ICT and PEP were prolonged, whereas ET and FT were shortened (P<001). Tei index in PH groups all significantly increased compared with control group (P<001). Statistical differences in IRT and FT were found between severe group and mild group and moderate group (P<005). ICT, PEP, ET and Tei index were significantly different between severe PH group and mild PH group (P<005). No significant difference in EMD was observed among the three PH groups and control group. CONCLUSION: PH leads to the dysfunction of the right ventricle. Right ventricular diastolic dysfunction happens in the early stage of PH and precedes systolic dysfunction in PH patients.

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备注/Memo

备注/Memo:
收稿日期：2013-03-07.基金项目：山东省交通厅科技项目资助（2006Y024） 通讯作者：隋树建，主任医师，主要从事心脏电生理、心脏超声研究 Email：suisj@163.com 作者简介：薛明华，副主任医师，硕士 Email：minghua.xue@126.com
更新日期/Last Update: 2013-09-30