肝中静脉血流频谱变化对肺动脉高压诊断的临床评价

发布时间：2018-04-13 04:27

本文选题：肺动脉高压 + 肝中静脉　；参考：《中国超声医学杂志》2015年04期

【摘要】：目的分析肺动脉高压患者肝中静脉血流多普勒频谱的变化规律,筛选适合临床使用的诊断肺动脉高压的新指标。方法收集预行封堵术的先天性心脏病患者80例,经右心导管测量其肺动脉压力,经超声测量肝中静脉频谱各波的峰值速度(V)和速度时间积分(VTI),评价其对肺动脉高压的预测价值,确定截断点。结果与对照组相比,肺动脉高压组SV、SVTI、DV、DVTI降低,ARV、ARVTI、ARV/SV、ARVTI/SVTI、ARV/(SV+DV)、ARVTI/(SVTI+DVTI)升高,差异具有统计学意义(P0.05)。相关分析显示ARV/SV、ARV/(SV+DV)、ARVTI/(SVTI+DVTI)比值与肺动脉平均压具有相关性(r=0.529、0.575、0.438,P均0.001)。ROC曲线分析结果显示ARV/(SV+DV)比值对于肺动脉高压的诊断效果优于其他参数,ARV/(SV+DV)比值=0.30时,对肺动脉高压诊断的灵敏度85.37%、特异度75.00%。结论以肝中静脉ARV/(SV+DV)比值=0.30为界值,诊断肺动脉高压具有较好的灵敏度及特异度,可以作为超声心动图评价肺动脉高压指标的有力补充。
[Abstract]:Objective to analyze the changes of Doppler spectrum of intrahepatic venous blood flow in patients with pulmonary hypertension and to screen new indexes for diagnosis of pulmonary hypertension.Methods the pulmonary artery pressure was measured by right cardiac catheterization in 80 patients with congenital heart disease. The peak velocities of each wave of middle hepatic vein (VV) and velocity-time integral (VTI) were measured by ultrasound to evaluate its predictive value for pulmonary hypertension.Determine the cut-off point.Results compared with the control group, SVVTI DVTI decreased ARV / ARVTI / SVVTI / SVVTI / SVVTI / SVTI DVTI in pulmonary hypertension group, and the difference was statistically significant (P 0.05).Correlation analysis showed that there was a correlation between ARV / SVV / V V / V V / V V / V V / V V / V ratio and mean pulmonary artery pressure. The results of 0.001).ROC curve analysis showed that the ratio of ARV/(SV DVT was better than that of other parameters in the diagnosis of pulmonary hypertension (P < 0. 30).The sensitivity of diagnosis of pulmonary hypertension was 85.37 and the specificity was 75.00.Conclusion taking the ratio of ARV/(SV DVV of middle hepatic vein as the threshold value, the diagnosis of pulmonary hypertension has good sensitivity and specificity. It can be used as an effective complement to echocardiography in the evaluation of pulmonary hypertension.
【作者单位】：吉林医药学院口腔影像系;第四军医大学唐都医院超声科;沈阳军区总医院先心病内科;第四军医大学唐都医院心内科;吉林医药学院附属医院特诊科;
【基金】：吉林省科技发展计划项目(No.20130522016JH) 吉林市科技计划项目(No.201464046)
【分类号】：R544.1;R445.1

【参考文献】