超声心动图评价肺栓塞患者右心室功能的研究

发布时间：2018-04-23 00:01

本文选题：超声心动图 + Tei指数　；参考：《广西医科大学》2012年硕士论文

【摘要】：目的：运用二维超声心动图(two-dimensional echocardiography,2DE)、组织多普勒成像技术(tissue Doppler imaging, TDI)、实时三维超声心动图(real-time three dimensional echocardiography, RT-3DE)评估肺栓塞患者右心室功能,探讨不同方法在临床评价肺栓塞患者右心室功能的准确性、敏感性及优越性。方法：28例肺栓塞患者,男性16例,女性12例,平均年龄(56.77±11.01)岁,根据预期的肺栓塞相关早期病死率进行危险分层为高危、中危、低危3个组,每组分别为8、12和8例；正常对照组30例,男性18例,女性12例,平均年龄(54.83±9.57)岁,经详细询问病史、体格检查、心电图及心脏超声检查证实为健康人。所有研究对像行2DE、TDI和RT-3DE检查,测算其右心常规超声指标、右心室Tei指数、右心室舒张期末容积(right ventricular end-diastolic volume, RVEDV)、右心室收缩期末容积(right ventricular end-systolic volume, RVESV)、右心室每搏输出量(right ventricular stroke volume, RVSV)及右心室射血分数(right ventricular ejection fraction, RVEF)。应用SPSS 13.0 for windows统计软件进行分析,多组间比较采用方差分析,组间两两比较采用SNK检验,检验水准a=0.05。结果：与对照组相比,肺栓塞患者高危组具有较明显的右心扩大及肺动脉高压征象,其右室Tei指数、RVEDV、RVESV明显增大(P0.05),RVEF明显减小(P0.05)；中危组尽管没有明显右心增大,但其右室Tei指数、RVEDV、RVESV、RVEF均已出现异常(P0.05)；低危组的右室Tei指数、RVEDV、RVESV、RVEF与对照组相比,差异无统计学意义(P0.05)。中危组的右室Tei指数、RVEDV、RVESV大于低危组而小于高危组；中危组的RVEF小于低危组而大于高危组。结论：肺栓塞患者的右心室功能可正常,亦可不同程度受损；TDI技术测量右室Tei指数和RT-3DE测量RVEF均可客观、准确、较敏感反映肺栓塞患者右室功能变化,是评价其右室功能的较好指标。
[Abstract]:Objective: to evaluate the right ventricular function in patients with pulmonary embolism by two-dimensional echocardiography, tissue Doppler imaging and real-time three dimensional echocardiography (RT-3DEE). To evaluate the accuracy, sensitivity and superiority of different methods in evaluating right ventricular function in patients with pulmonary embolism. Methods Twenty eight patients with pulmonary embolism, 16 males and 12 females, with an average age of 56.77 卤11.01 years, were classified as high risk, moderate risk and low risk group according to the expected early mortality of pulmonary embolism. 30 normal control group (male 18, female 12, mean age 54.83 卤9.57), were confirmed to be healthy by detailed inquiry of medical history, physical examination, electrocardiogram and echocardiography. All the subjects were examined by 2DED TDI and RT-3DE, and the right ventricular Tei index and the normal echocardiographic index of the right heart were measured. Right ventricular end-diastolic volume, right ventricular end-diastolic volume, right ventricular end-systolic volume, right ventricular stroke volume, right ventricular stroke volume and right ventricular ejection fractionation. The statistical software of SPSS 13.0 for windows was used to analyze, the analysis of variance was used in the comparison between groups, and the SNK test was used to test the level of A0.05. Results: compared with the control group, the high risk group of pulmonary embolism had obvious signs of right heart enlargement and pulmonary hypertension, and the right ventricular Tei index (RVEDVV) increased significantly (P 0.05) and the RVEF decreased significantly (P 0.05), while in the middle risk group, the right heart did not increase significantly. However, the RVEF of RVEDVV, RVESVV, RVEF of RVEDVV, RVESVV, RVEF of RVEDVV, RVESVV, RVEF of RVEDVV, RVESVV, RVEVEF of RVEDVV, RVESVV, RVEF of RVEDVV, RVESVV, RVEF of RVEVV VEF in RVEDVV RV DVV RVESV in moderate risk group was higher than that in low risk group but smaller than that in high risk group, and RVEF in middle risk group was lower than that in low risk group but larger than that in high risk group. Conclusion: the right ventricular function in patients with pulmonary embolism is normal, and the right ventricular Tei index and RVEF measured by RT-3DE can be objective and accurate, which can reflect the changes of right ventricular function in patients with pulmonary embolism. It is a good index to evaluate the right ventricular function.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R563.5

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