常规超声心动图与实时三维超声心动图在评价重度三尖瓣返流患者右心功能方面的相关性研究

发布时间：2018-03-03 19:30

本文选题：重度三尖瓣返流　切入点：实时三维超声心动图　出处：《扬州大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨常规超声心动图测得的三尖瓣环收缩期位移(TAPSE)、Tei指数、三尖瓣环收缩期峰值速度(S')与实时三维超声心动图(RT-3DE)测得的右室射血分数(RVEF)在重度三尖瓣返流(TR)患者右心功能评价中的相关性及临床应用价值。资料与方法:收集2016年2月至2017年2月在我院住院的重度TR的18例患者为研究对象,其中男7例,女11例,年龄73.7±9.7岁,身体质量指数(BMI)21.1±3.4Kg/m2。选取与重度TR组年龄相当的正常成人20例为对照组,其中男11例,女9例,年龄67.5±9.3岁,BMI 23.1±3.97 Kg/m2。所有重度TR组与对照组患者均行常规二维超声心动图、组织多普勒(TDI)技术、M型超声心动图以及RT-3DE检查。利用M型超声心动图测量TAPSE,利用TDI技术测量右室游离壁三尖瓣瓣环处Tei指数和三尖瓣环S'。应用RT-3DE测量右室舒张末容积(RVEDV)、右室收缩末容积(RVESV)、右室射血分数(RVEF)等参数。分析各组内常规超声心动图与RT-3DE各定量参数之间的相关性,同时比较研究组和对照组之间常规超声心动图与RT-3DE各定量参数之间的差异。结果:1、重度TR组内TDI条件下测得的三尖瓣环S'和右室游离壁三尖瓣瓣环处Tei指数与RT-3DE测得的RVEF具有显著相关性(r=0.680,P=0.002及r=-0.531,P=0.023),其中三尖瓣环S'与RVEF的相关性最为显著(r=0.680,P=0.002)。2、对照组内M型超声心动图测得的TAPSE以及TDI条件下测得的右室游离壁三尖瓣瓣环处Tei指数和三尖瓣环S'与RVEF均存在显著的相关性(r=0.534,P=0.015、r=-0.657,P=0.002 及 r=0.666,P=0.001)。3、与对照组相比,重度TR组三尖瓣环S'以及RVEF值都明显减低(P=0.037、P=0.002)。4、在重度TR组内,TR面积与RVEF值具有显著相关性(r=-0.511,P=0.030),表明随着TR程度的进一步加重,重度TR患者的右心功能降低的也更为显著。结论:1、对照组内,M型超声心动图测得的TAPSE以及TDI条件下测得的右室游离壁三尖瓣瓣环处Tei指数和三尖瓣环S'与RT-3DE测得的RVEF在评估右心功能方面具有显著相关性。2、重度TR组内,TDI条件下测得的三尖瓣环S'和右室游离壁三尖瓣瓣环处Tei指数与RT-3DE测得的RVEF在评估重度TR患者的右心功能方面具有显著相关性。3、与对照组相比,重度TR组患者的三尖瓣环S'以及RVEF值都明显减低。4、在重度TR组内,随着TR程度的进一步加重,患者的右心功能降低也更为显著。
[Abstract]:Objective: to investigate the systolic displacement of tricuspid annulus and the Tei index measured by conventional echocardiography. The correlation between right ventricular ejection fraction (RVEF) and right ventricular ejection fraction (RVEF) in patients with severe tricuspid regurgitation (TRT) and the clinical application value of tricuspid annular systolic peak velocities (RV) and real-time three-dimensional echocardiography (RT-3DED) in the evaluation of right ventricular function in patients with severe tricuspid regurgitation (TRV). Data and methods:. From February 2016 to February 2017, 18 patients with severe tr in our hospital were selected as study subjects. There were 7 males and 11 females, aged 73.7 卤9.7 years, with BMI of 21.1 卤3.4 kg / m2. 20 normal adults of the same age as the severe tr group were selected as the control group, including 11 males and 9 females. Age 67.5 卤9.3 years old, BMI 23.1 卤3.97 kg / m2. All patients with severe tr and control group underwent routine two-dimensional echocardiography. Tissue Doppler echocardiography, M-mode echocardiography and RT-3DE were used to measure TAPSE. TDI technique was used to measure Tei index and tricuspid annulus of right ventricular free wall. RT-3DE was used to measure right ventricular end-diastolic value. The correlation between conventional echocardiography and quantitative parameters of RT-3DE was analyzed, such as RV VV, right ventricular end-systolic volume (RV VV), right ventricular ejection fraction (RVEF) and so on. The quantitative parameters of conventional echocardiography and RT-3DE were compared between the study group and the control group. Results the Tei index of tricuspid annulus and Tei index at right ventricular free wall tricuspid annulus and RT-3DE were measured under the condition of TDI in severe tr group. The RVEF was significantly correlated with RV 0.680, P0. 002 and RV-0. 531, P = 0. 023. The correlation between tricuspid annulus S 'and RVEF was the most significant. In the control group, the TAPSE measured by M-mode echocardiography and the Tei index of right ventricular free wall tricuspid annulus measured under TDI condition were the most significant. There was a significant correlation between S 'and RVEF in tricuspid annulus. The values of S 'and RVEF of tricuspid annulus decreased significantly in severe tr group. The area of tr was significantly correlated with RVEF value in severe tr group, indicating that the degree of tr increased with the severity of tr. Conclusion in the control group, TAPSE measured by M-mode echocardiography and Tei index at tricuspid annulus of right ventricular free wall and tricuspid annulus S 'and RT-3DE measured under TDI condition were also significantly decreased in patients with severe tr. Conclusion\%\%\%\%\%\%\%\%\%\%\%\%\%\%\%\%\%\%\%\%\%\%? In severe tr group, tricuspid annulus S', right ventricular free wall tricuspid annulus Tei index and RVEF measured by RT-3DE were used to evaluate the right ventricular function in patients with severe tr. There was significant correlation. 3, compared with the control group, The values of S 'and RVEF of tricuspid annulus decreased significantly in severe tr group. In severe tr group, the right ventricular function decreased more significantly with the further aggravation of tr.
【学位授予单位】：扬州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R540.45;R542.53

【参考文献】