组织多普勒Tei指数评价西地那非对肺动脉高压患者右室功能的影响

Influence of Sildenafil Assessed by Doppler Tei Index Derived from Tissue on Right Ventricular Function in Patients with Pulmonary Artery Hypertension

目的利用组织多普勒Tei指数观察肺动脉高压患者口服西地那非后对右室功能的影响。方法入选者为我院21例肺动脉高压病人,给予西地那非25 mg,每日口服3次,在服药前及服药后4 w、12 w,分别测量右室大小、右室射血分数、肺动脉收缩压及组织多普勒三尖瓣环的等容舒张时间(IRT)、等容收缩时间(ICT)、射血时间(ET)、右室Tei指数及6 min步行距离(6MWD)变化。结果服药4 w后,和基线比较,6MWD增加(346.4±32.1)VS(367.3±36.7),P<0.05),右室三尖瓣环的IRT、ICT缩短(P<0.05),右室Tei指数减低(P<0.05),12 w后,6MWD进一步地增加(346.4±32.1)VS(398.7±38.9),(P<0.01),肺动脉收缩压减低(76.7±20.5)mmHg VS(64.2±18.1)mmHg(P<0.05),ET延长(P<0.05),右室三尖瓣环的IRT、ICT缩短,右室Tei指数减低(P<0.01)。结论口服西地那非可以降低肺动脉压,改善右室功能,右室Tei指数可以敏感地反应右室功能变化。

Objective To investigate influence of taking sildenafil orally on right ventricle （RV） function in patients with pulmonary arterial hypertension with Doppler Tei index from tissue. Methods 21 patients are enrolled and administered with Sildenafil （25 mg, TID, PO）. Before and after taking medicine 4 weeks and 12 weeks, the size, ejection fraction of RV, pulmonary arterial systolic pressure, isovolumic relaxation time （IRT）, isovolumic contraction time （ICT）, ejection time （ET） of tissue Doppler tricuspid ring, Tei index of RV and 6 minutes walk distance（6MWD） were measured. Results After taking medicine 4 weeks, the 6MWD, compared with the baseline, increased by （346.4±32.1） vs. （367.3±36.7） （P〈0.05）. IRT, ICT and Tei index of RV decreased （P〈0.05）. After 12 weeks, 6MWD further increased by （346.4＋32.1） vs. （398.73-38.9） （P〈0.01）. Pulmonary arterial systolic pressure decreased by （76.7±20.5） mmHg vs. （64.2±18.1） mmHg （ P〈0.05）. ET increased （P〈0.05）, ICT, IRT and Tei index decreased（P〈0.01）. Conclusion Taking Sildenafil could decrease pulmonary artery pressure and improve RV function. Tel index of RV is a sensitive parameter to react function change of RV.