摘要
目的应用超声心动图分析急性肺血栓栓塞患者发病时间对溶栓治疗效果的影响。方法肺血栓栓塞患者249例,根据发病时间分为三组:Ⅰ组,病程≤4周;Ⅱ组,4周<病程≤12周;Ⅲ组,病程>12周。溶栓治疗前后应用超声心动图检测右心功能,测量指标包括测量右室前后径(RVD)、右室横径(RVTD)、左室横径(LVTD)、右室横径/左室横径(RVTD/LVTD)、右房横径(RATD)、左房横径(LATD)、右房横径/左房横径(RATD/LATD)、右室前壁厚度(RVAWT)、右室前壁运动幅度(RVWAM)、主肺动脉内径(DMPA)、三尖瓣迫流压差(PGTI)、肺动脉收缩压(PASP)。结果治疗前所有患者右心功能指标均明显异常,三组间差异无统计学意义(P>0.05)。系统溶栓治疗1个月后,Ⅰ组和Ⅱ组患者RVD、RVTD、RVTD/LVTD、RATD、LATD、RATD/LATD、RVWAM、DMPA、PGTI、PASP均较治疗前改善(P<0.01);Ⅲ组患者RVD、LVTD、RVTD/LVTD、RATD、DMPA、PGTI、PASP也得到改善(P<0.01)。其中RVTD/LVTD、PGTI、RATD/LATD三项指标为超声心动图判断溶栓治疗效果的主要指标。结论急性肺栓塞患者发病时间直接影响其溶栓治疗后心脏结构及功能改善的情况;同时右心比例及PGTI对于快速判断疗效有重要价值。
Objective To analyze the curative effect of different course in pulmonary thromboembolism patients. Methods Two hundred and forty-nine patients were diagnosed by pulmonary angiography or nuclide perfusion scintigraphy, which were divided into three groups by different course. All patients were carried on echocardiography before and after treatment. Results RVD, RVTD, RVTD/LVTD, RATD, LATD, RATD/LATD, RVWAM, DMPA, PGTI and PASP improved obviously in Ⅰ ＆ Ⅱ group patients （P〈0.01）, while LATD and RVAWT didn＇t change clearly. RVD, LVTD, RVTD/LVTD, RATD, DMPA, PGTI and PASP improved in Ⅲ group as well （P〈0.01）. The key indexes estimating curative effect by echocardiography were RVTD/LVTD, PGTI and RATD/LATD. Conclusion The courses of pulmonary thromboembolism affect patients＇ heart structure and function improvements directly. Right heart proportion and PGTI have important value to judge the curative effect rapidly.
出处
《中国医学影像技术》
CSCD
北大核心
2008年第11期1774-1776,共3页
Chinese Journal of Medical Imaging Technology
基金
国家“十五”肺栓塞规范化诊治方法的研究课题(2004BA703B07)
