速度向量成像技术评价尘肺病患者右心室收缩功能研究

Evaluation of right ventricular systolic function in pneumoconiosis patients by velocity vector imaging

目的研究速度向量成像技术(VVI)测量右心室壁变化与尘肺病患者右心室收缩功能降低的相关性,并寻找早期预测右心室收缩功能降低的指标。方法选取2020年12月至2021年11月该院收治的148例尘肺病患者,采用常规超声心动图测量右心室心肌做功指数——Tei指数[Tei(TDI)]、三尖瓣反流速度、三尖瓣环收缩期位移(TAPSE)等,使用VVI测量右心室壁变化相关参数,收集尘肺病分期、脑利钠肽(BNP)等信息,比较不同分期患者各项参数的差异性,分析BNP、肺动脉高压与各项参数的关系。结果与Ⅰ、Ⅱ期患者比较,Ⅲ期患者Tei(TDI)、TAPSE、右心室长轴曲线平均应变速度(TVC)、右心室长轴节段平均位移(TDS)、右心室长轴曲线平均位移(TDC)比较,差异均有统计学意义(P<0.05);不同分期患者BNP、频谱多普勒测量右心室做功指数——Tei指数[Tei(PW)]、右心室面积变化率(FAC)、右心室长轴节段平均应变速度(TVS)、右心室长轴节段平均应变(TSS)、右心室长轴曲线平均应变(TSC)、右心室整体纵向应变(GLS)、右心室长轴节段平均应变率(TSRS)、右心室长轴曲线平均应变率(TSRC)比较,差异均无统计学意义(P>0.05)。各项参数均与BNP明显相关,差异均有统计学意义(P<0.05);其中TSRC及FAC相关性较高。有无肺动脉高压患者TVS、TVC、GLS、TDS、TDC、TAPSE、Tei(PW)、FAC、BNP比较,差异均有统计学意义(P<0.05)。结论Ⅲ期尘肺病患者VVI的应变速度、位移与Ⅰ、Ⅱ期尘肺病患者差异明显,表明VVI是一种能评估尘肺病患者右心室收缩功能的有效方法。

Objective To study the correlation between the changes of right ventricular wall measured by velocity vector imaging(VVI)and the decrease of right ventricular systolic function in patients with pneumoconiosis,and to find the early index to predict the decrease of right ventricular systolic function.Methods The right ventricular myocardial work index——Tei index[Tei(TDI)],tricuspid regurgitation velocity and tricuspid annular plane systolic excursion(TAPSE)were measured by conventional echocardiography in 148 patients with pneumoconiosis at different stages who were diagnosed in this hospital from December 2020 to November 2021.The parameters related to the changes of right ventricular wall were measured by VVI.The information of pneumoconiosis stages and brain natriuretic peptide(BNP)were collected.The differences of various parameters in patients with different stages were compared,and the relationship between BNP,pulmonary hypertension and various parameters was analyzed.Results Compared with patients in stageⅠandⅡ,patients in stageⅢhad statistically significant differences in Tei(TDI),TAPSE,mean strain velocity(TVC),mean segmental displacement(TDS)and mean displacement(TDC)of right ventricular long axis curve(P<0.05).There were no differences in BNP,right ventricular work index——Tei index[Tei(PW)],right ventricular fractional area change(FAC),mean strain velocity(TVS),mean strain of right ventricular long-axis segment(TSS),mean strain of right ventricular long-axis curve(TSC),total longitudinal strain(GLS),mean strain rate of right ventricular long-axis segment(TSRS)and the mean strain rate of right ventricular long-axis curve(TSRC)between patients with different stages(P>0.05).All the parameters were obviously related to BNP,and the differences were statistically significant(P<0.05).Among them,TSRC and FAC had high correlation.There were significant differences in TVS,TVC,GLS,TDS,TDC,TAPSE,Tei(PW),FAC and BNP between patients with and without pulmonary hypertension(P<0.05).Conclusion The strain rate and displacement of VVI technology in stageⅢpneumoconiosis patients are significantly different from those in stageⅠandⅡpneumoconiosis patients,indicating that VVI is an effective method for evaluating right ventricular systolic function in pneumoconiosis patients.