实时三维超声心动图评价左心疾病相关性肺高血压患者右室重构过程

发布时间：2018-04-12 11:36

本文选题：实时三维超声心动图 + 右心室功能　；参考：《中国超声医学杂志》2015年04期

【摘要】：目的应用实时三维超声心动图(RT-3DE)评价左心疾病相关性肺高血压(LHD-PH)患者右室重构过程,初步探讨RT-3DE相关参数对被动性PH与反应性PH的鉴别诊断价值。方法健康志愿者40例,LHD-PH患者65例,根据肺血管阻力(PVR)将PH患者分为:被动性PH组和反应性PH组。应用RT-3DE测量右室舒张末期容积指数(RVVId)、收缩末期容积指数(RVVIs)、每搏量(RVSV)和射血分数(RVEF)。结果与对照组比较,PH亚组RVVId、RVVIs和RVSV增加,反应性PH组RVEF减低(均P0.05);与被动性PH组比较,反应性PH组RVVId、RVVIs升高,RVEF降低(均P0.05)。ROC分析显示,RVEF、RVVId、RVVIs分别为37.25%、42.03ml/m2、26.42ml/m2时,其鉴别被动性PH与反应性PH的灵敏度分别为72%、66%、62%,特异度分别为75%、75%、78%。结论 RT-3DE能定量评价LHD-PH患者右室重构过程;RVEF、RVVId和RVVIs在被动性PH与反应性PH的鉴别诊断中有一定临床价值。
[Abstract]:The purpose of the application of real-time three-dimensional echocardiography (RT-3DE) to evaluate the correlation of left heart disease and pulmonary hypertension (LHD-PH) patients with right ventricular remodeling, a preliminary study of the RT-3DE related parameters for diagnosis and differential diagnosis of passive PH and reactive PH. Methods 40 healthy volunteers, 65 patients with LHD-PH, according to the pulmonary vascular resistance (PVR) PH the patients were divided into group PH: passive and reactive PH group. RT-3DE was used to measure right ventricular end diastolic volume index (RVVId), end systolic volume index (RVVIs), stroke volume (RVSV) and ejection fraction (RVEF). Results compared with the control group, PH subgroup RVVId, RVVIs and RVSV increased the reaction of PH, group RVEF decreased (P0.05); compared with the passive PH group, reactive PH group RVVId, RVVIs increased, RVEF decreased (P0.05).ROC analysis showed that RVEF, RVVId, RVVIs were 37.25%, 42.03ml/m2,26.42ml/m2, the sensitivity of differential passive PH and reactive PH were 72% 66. %, 62%, specificity 75% and 75%, 78%. conclusion RT-3DE can quantitatively evaluate the right ventricular remodeling process in LHD-PH patients. RVEF, RVVId and RVVIs have certain clinical value in the differential diagnosis between passive PH and reactive PH.

【作者单位】：重庆医科大学超声影像学研究所及附属第二医院超声科超声分子影像重庆市重点实验室;
【基金】：国家自然科学基金(No.81471675) 重庆市医学科研计划项目(No.20142035) 重庆市科委科技项目(No.cstc2014jcy jA10031)
【分类号】：R445.1;R544.1

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