组织多普勒Tei指数评价风湿性心脏病患者右室功能及其影响因素的研究

Study on right ventricular function of patients with rheumatic heart disease using tissue Doppler imaging-derived Tei index and its effect factors

目的探讨应用脉冲波组织多普勒显像技术(PWTDI)所测Tei指数评价风湿性心脏病(RHD)患者右室功能的临床价值。方法测量36例RHD患者及20例健康对照者的右心常规超声指标,同时记录三尖瓣环的PWTDI频谱图,测量相关时间间期,并计算出Tei指数。结果①36例RHD患者中,A组(n=16)有较明显的肺动脉高压及右心扩大,B组(n=20)患者虽有少量三尖瓣返流及轻度肺动脉高压,却无右心扩大征象。但A、B两组患者的Tei值均明显增大,与对照组相比均有显著性差异(P<0.01);②单元线性相关分析表明:正常对照组中,Tei指数与年龄、心率均无相关性(P>0.05);RHD患者中,Tei指数与年龄呈正相关(P<0.05),而与心率无相关性(P>0.05)。结论用右室三尖瓣环的PWTDI法获得的Tei指数可以较敏感的反映RHD患者右室功能的变化,是评价其右室整体功能的较好指标。

Objective To investigate the value of Tei index derived from pulsed wave-tissue Doppler imaging （PW-TDI） in evaluating right ventricular function of patients with rheumatic heart disease （RHD）. Methods A total of 36 patients with RHD and 20 healthy volunteers were involved in this study. Some traditional ultrasonic parameters of right heart, time parameters and TDI-derived Tei Index were measured and compared. PW-TDI data were acquired from tricuspid annular on apical four-chamber view. Results ① Group A （n= 16） had characteristic echocardiographic appearance of right ventricular dysfunction, while a normal right cardiac performance was judged in group B. However, the TDI-derived Tel Index of group A and B were different significantly compared with the healthy volunteers （P〈0.01）. ② In volunteers, Tel index was independent on age and heart rate （P〉0.0g） ; but in patients with RHD, Tei Index correlated positively with age （P〈0.0g）, and was independent on heart rate （P〉0.05）. Conclusion Tei index measured by PW-TDI acquired from tricuspid annular is a sensitive indicator of right ventricular global function.