多普勒超声心动图筛查门肺高压症的临床研究

Clinical study on the value of Doppler echocardiography in screening portopulmonary hypertension

目的:调查门肺高压症在国内的发病情况,评估二维多普勒超声心动图作为筛查方法的临床效果。方法:于77例接受手术治疗的肝硬化门静脉高压症病人,行术前二维多普勒超声心动图检查,测算肺动脉收缩压和肺加速时间以筛查门肺高压症病人;并和标准诊断法右心导管法结果进行比较。结果:本研究样本人群中的门肺高压症发病率为3.9%,二维多普勒超声心动图筛查试验的灵敏度为100%,特异度为87.8%,真实度88.3%,阳性预测值为25%,阴性预测值为100%。结论:国内的门肺高压症发病情况与国际上报道的相似。二维多普勒超声心动图筛查法的灵敏度和阴性预测值高;阴性结果有助于排除门肺高压症,而阳性结果必须经右心导管法确诊。

Objective To investigate the incidence of portopulmonary hypertension, and to evaluate the value of Doppler eehocardiography in screening for portopuhnonary hypertension in patients with portal hypertension. Methods Seventy seven patients with liver cirrhosis were studied by Doppler Eehoeardiography preoperatively; systolic puhnonary arterial pressure and puhnonary acceleration time were estimated in sereening portopuhnonary hypertension, subsequently, right heart pressure was measured by cardiac cathetherization before induction of anesthesia. The results obtained by these 2 methods were compared. Results The ineidence of portopulmonary, hypertension in the patients with portal hypertension studied was 3.9%. The sensitivity, specificity, aceuracv rate, positive predictive value and negative predictive value of Doppler echoeardiography in screening for portopulmonary hypertension were 100%, 87.8%, 88.3%, 25% and 100%, respeetively. Conclusions The incidence of portopuhnonary hypertension obtained in this study is similar to those from the literature. As a screening test, Doppler echocardiography offers very high sensitivity and negative predictive value. Negative results can be used directly to exclude portopulmonary hypertension, while positive results should be checked by cardiac cathetherization.