组织多普勒Tei指数评价肺动脉高压患者右室功能及其影响因素的研究

Study on Right Ventricular Function of Patients with Pulmonary Hypertension Using Tei Index and its Effect Factors

目的探讨应用脉冲波组织多普勒显像技术(PW-TDI)测量Tei指数评价肺动脉高压患者右室功能的临床价值。方法测量36例肺动脉高压患者及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PW-TDI频谱图,测量相关时间间期,并计算出Tei指数。结果(1)36例肺动脉高压患者中,16例(A组)有较明显的肺动脉高压及右心扩大,20例(B组)患者虽有轻度肺动脉高压,却无右心扩大征象。但A、B两组患者的Tei值均明显增大,与对照组比较差异均有统计学意义(P<0.01);(2)正常对照组中,Tei指数与年龄、心率均无相关性(P>0.05);肺动脉高压患者中,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PW-TDI法获得的Tei指数可以较敏感地反映肺动脉高压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 ventrieular function of patients with pulmonary hypertension （PH）. Methods A total of 36 patients with PH and 20 healthy volunteers were involved in this study. Some traditional ultrasonic parameters of fight heart,PW-TDI spectrogram of tricuspid annulus,time parameters and TDI-derived Tei index were measured and compared. Results （ 1 ）group A （ a = 16） had characteristic echocardiographic appearance of fight ventrieular dilatation. Group B （n = 20） had no characteristic echocardiographie appearance,but had mild to moderate pulmonary hypertension. However,the TDI-derived Tei index of group A and B were different significantly compared with the healthy volunteers （P 〈 0. 01 ）. （2） In volunteers,Tei index was independent on age and heart rate （P 〉0. 05）;but in patients with PH, Tei index correlated positively with age （P 〈0.05）,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 ventrieular global function.