摘要
目的探讨右心室功能参数变化在检测心脏移植术后排异反应的价值。方法入组原位心脏移植并于术后行实时三维超声心动图检查的患者28例,分为心脏移植术后排异组7例及非排异组21例,均经心内膜活检证实;无相关心脏疾病病史,辅助检查均正常者为正常对照组25例。所有患者均行常规二维超声心动图检查并应用脉冲多普勒记录三尖瓣、肺动脉瓣血流图,实时三维超声心动图采集右心室全容积三维图像。结果排异组、非排异组的左房内径显著大于正常对照组,差异有统计学意义(P<0.05),而排异组、非排异组、正常对照组的左心室射血分数三组间差异无统计学意义(P>0.05);对照组、非排异组、排异组的右心室Tei指数指标呈递增趋势,排异组右心室Tei指数明显高于非排异组和对照组,差异有统计学意义(P<0.05);对照组、非排异组、排异组的右心室射血分数呈递减的趋势,三组间差异均有统计学意义(P均<0.01);右心室射血分数(RVEF)与右心室Tei指数间有较好的相关性(r=-0.332,P=0.024);右心室流入道及流出道的局部射血分数无论是排异组还是非排异组均低于正常对照组,差异有统计学意义(P<0.05),而且排异组右心室流入道的射血分数较非排异组显著降低,差异有统计学意义(P<0.05)。结论右心室Tei指数及实时三维超声心动图能够快速、准确地评价右心室整体收缩功能,且有助于心脏移植术后排异反应的预测和诊断。
Objective To investigate the variety of right ventricular function in detecting allograft rejection in patients with heart transplant(HT).Methods Twenty five healthy volunteers (control group) and twenty eight HT patients (HT group) were enrolled,and HT group were further divided into the non-rejected group (HT-nr group) and rejected group(HT-r group) based on the endocardial biopsy.All the participants received two-dimensional echocardiography and pulse Doppler.Real time three-dimensional echocardiography (RT3DE) 'full volume' imaging was acquired in four chamber view in all participants to evaluate the parameters concerning systolic function of right ventricle (RV).Results Left atria diameter in HT-n group and HT-r was enlarger than that of control group (P<0.05).Left ventricular ejection fraction (LVEF) had no significant different in three groups (all P>0.05).Tei index of RV in HT-r group was higher than that in HT-n group and control group (all P<0.05).RVEF of HT-r group was lower than those of HT-n group and control group.And RVEF was negatively correlated with Tei index of RV(r=-0.332,P=0.024).EF of right ventricular inflow tract (RVIT) in HT-r was lower than that in HT-nr (P<0.05). Conclusions Tei index of RV and RT3DE can quickly and accurately evaluate right ventricular systolic function and help to diagnose the allograft rejection after HT.
出处
《中华临床医师杂志（电子版）》
CAS
2011年第7期1871-1876,共6页
Chinese Journal of Clinicians(Electronic Edition)
基金
上海市自然科学基金(09ZR1406300)
