Tei指数综合评价肝硬化患者心功能及其与Child-Pugh的相关性研究

STUDY OF RELATIONSHIP BETWEEN CARDIAC FUNCTION EVALUATED WITH Tei INDEX AND Child-Pugh GRADE IN PATIENTS WITH LIVER CIRRHOSIS

目的应用心肌运动指数即Tei指数综合评价肝硬化患者心功能及其与Chlid-Pugh的相关性。方法肝硬化患者76例,按Child-Pugh肝功能分级标准分为Child A组(n=31)、Child B组(n=25)和Child C组(n=20),健康志愿者30例作对照组,应用脉冲多普勒方法,计算左、右心室的Tei指数,进行组间比较,并与Child-Pugh分级做相关分析。结果肝硬化失代偿期(Child B级、Child C级)组左心室的Tei指数及等容舒张时间/心室射血时间(isovolumic relaxation time/ejection time,IRT/ET)与对照组比较均明显升高(P<0.05);右心室的Tei指数及IRT/ET与对照组比较,差异无统计学意义(P>0.05);左心室Tei指数与Chlid-Pugh分级呈正相关(r=0.625,P<0.01)。结论肝硬化患者存在左室收缩功能和舒张功能不全,与肝功能损害严重程度相一致。

Objective To assess the cardiac function by myocardial performance index namely Tel index in patients with liver cirrhosis, and analyse the relationship between cardiac function and the Child - Pugh grade. Methods Seventy - six patients with liver cirrhosis were divided into group A, B and C（ Child A group ,Child B group and Child C group） according to the Child -Pugh score,30 heahhy volunteers served as control group. The Tei index of left and right ventricle was calculated by pulse doppler method and compared between groups. The correlation of Tei index with Child - Pugh grading was analysed. Results The left ventricular Tel index and the isovolumic relaxation time/ejection time（ IRT/ ET ）of decompensated cirrhosis group Child B and Child C group were significantly increased compared with healthy control group （P 〈0.05 ）. There was no significant difference in right ventricular Tei index and IRT/ET between cirrhosis group and control group （P 〉 0.05 ）. Left ventricular Tei index and Child -Pugh classification were positively correlated. Conclusion The left ventricular systolic function and diastolic function of patients with cirrhosis are impaired, and the degree of cardiac insufficiency is related to the damage of liver function