脉冲波组织多普勒成像评价风湿性心脏病右室功能

Assessment of Right Ventricular Function by Pulsed Wave-Tissue Doppler Imaging in Patients with Rheumatic Heart Disease

目的:应用脉冲波组织多普勒成像技术(PW-TDI)分析风湿性心脏病(RHD)患者右室收缩与舒张功能的变化特点。方法:测量36例RHD患者右心常规超声指标,按肺动脉压分为高、中、低组(A、B、C组),比较三组三尖瓣环处的PW-TDI频谱图指标,并与24例健康者对照。结果:排除年龄因素影响后,与对照组比较,A组收缩功能Vs、PET、PET/ET无显著性差异(P>0.05),B组和C组Vs减低、PET延长、PET/ET增大(P均<0.05);而三组舒张功能较对照组Ve与Ve/Va均显著下降,IRT均显著延长(P均<0.05);结论:RHD患者早期存在右室舒张功能下降,肺动脉高压出现后,收缩及舒张功能均受损;三尖瓣环处Vs、PET/ET和Ve、Ve/Va、IRT可分别反映右室收缩和舒张功能变化。

Objective To investigate the change of right ventricular systolic and diastolic function in patients with rheumatic heart disease（RHD） by pulsed wave-tissue Doppler imaging （PW-TDI）.Methods Thirty-six patients with RHD were diveded into three groups（ groupA,B,C） based on the different pulmonary artery pressure after detecting the traditional ultrasonic parameters of right heart.The PW-TDI parameters of tricuspid annulus were compared during three groups,and 24 healthy volunteers were selected as control group.Results Compared with control group,the parameters Vs,PET,PET/ET of systolic function in group A had no obviously difference（P0.05）after excluding the influence of age;while in group B and group C,Vs was decreased,PET was prolonged and the value of PET/ET was increased significantly（P all0.05）;the parameters Ve,Ve/Va of diastolic function in three groups were all significantly decreased and IRT were all increased significantly（P all0.05）.Conclusion The diastolic function of right ventricular was decreased in early patients with RHD,the systolic and diastolic function were both impaired after pulmonary hypertension occurring;the parameters Vs,PET/ET and Ve,Ve/Va,IRT of tricuspid annulus could sensitively reflect the systolic and diastolic function change of right ventricular.