实时三维超声心动图评价肺动脉高压患者右心室收缩功能

Evaluation of Right Ventricular Systolic Function in Patients with Pulmonary Hypertension Using Real-time Three-dimensional Echocardiography

目的运用实时三维超声心动图(RT-3DE)评价肺动脉高压患者右心室收缩功能。资料与方法 97例肺动脉高压患者按照肺动脉收缩压分为3组:轻度组30例,中度组35例,重度组32例;选取31名正常成人作为对照。采用RT-3DE检测受试者右心室整体及三节段的舒张末期容积、收缩末期容积、搏出量和射血分数。结果中、重度组右心室整体收缩末期容积明显大于正常组及轻度组(P<0.05或P<0.01),右心室射血分数明显低于正常组及轻度组(P<0.01)。三节段研究显示:重度组右心室流入道的收缩末期容积明显大于正常组(P<0.05)及轻度组(P<0.01),中度组收缩末期容积大于轻度组(P<0.05);中、重度组的右心室射血分数均明显低于正常组及轻度组(P<0.01);小梁部舒张末期容积以中度组增大最为明显(P<0.05),中、重度组收缩末期容积明显增大(P<0.05),搏出量和射血分数各组间均无统计学意义(P>0.05)。右心室流出道的右心室收缩功能参数各组间均无统计学意义(P>0.05)。结论中度以上的肺动脉高压患者存在右心室整体及流入道收缩功能损害。

Purpose To evaluate the right ventricular systolic function in patients with pulmonary hypertension （PH） using real-time three-dimensional echocardiography （RT-3DE）. Materials and Methods 97 patients with PH were divided into three groups according to pulmonary arterial pressure （PASP） level： mild group consisted of 30 cases, moderate group consisted of 35 cases, severe group consisted of 32 cases. 31 healthy cases were included as controls. The end-diastolic volume （EDV）, end-systolic volume （ESV）, stroke volume （SV） and right ventricle ejection fraction （RVEF） of global right ventricle and inflow tract, trabeculae, outflow tract of all subjects were detected by using RT-3DE. Results Global RV ESV increased in moderate and severe groups （P0.05 or P0.01）, but RVEF decreased （P 0.01）. The rESV of RV inflow tract in the severe group was higher than that of normal and mild groups; the rESV of RV inflow tract of moderate group was higher than that of mild group （P0.05）, but rRVEF of the two groups were decreased （P0.01）. Mild group had increased RV trabeculae regional rEDV （P0.05）; moderate and severe groups had increased RV trabeculae regional rESV, but rSV and rRVEF were not statistically different in all groups （P 0.05）. Regional volume and ejection fraction of RV outflow tract were not statistically different in all groups （P0.05）. Conclusion Global RVEF and rRVEF of RV inflow tract are decreased in moderate and severe PH patients.