组织多普勒成像Tei指数评价特发性肺间质纤维化患者右心功能的价值

Assessment of right ventricular function in patients with idiopathic pulmonary fibrosis by Tei index derived from tissue Doppler imaging

目的:探讨组织多普勒成像(TDI)Tei指数在评价特发性肺纤维化(IPF)患者右心功能上的应用价值。方法:选择具有肺动脉高压(PAH)的IPF患者21例,根据PAH的程度分为轻度(IPF-Ⅰ组,7例)、中度(IPF-Ⅱ组,8例)和重度(IPF-Ⅲ,6例)3组,采用TDI技术测量各组患者右房横径、右室横径、右室前壁厚度、主肺动脉内径、肺动脉收缩压,获取右室游离壁三尖瓣环位点的频谱图,计算右室Tei指数,与对照组21例(健康成人)进行对比分析。结果:右室Tei指数在对照组、IPF-Ⅰ、Ⅱ、Ⅲ组依次增高,分别为0.27±0.11、0.37±0.10、0.54±0.13和0.70±0.14;IPF各组右室Tei指数相互比较差异有统计学意义(P<0.05),与对照组比较差异有统计学意义(P<0.05)。结论:晚期IPF患者由于纤维化和肺动脉高压使右心功能受损,右室Tei指数能有效评价其右心功能状况。

Objective To investigate the value of Tei index derived from tissue Doppler imaging in the assessment of right ventricular function in patients with idiopathic pulmonary fibrosis （IPF）. Methods 21 patients with pulmonary artery hypertension （PAH） complicated with IPF were divided into mild （IPF- I group, n = 7）, moderate （IPF-II group, n = 8） and severe （IPF-III group, n = 6）, and 21 cases of health adults were included as control group. The right atrium horizontal path, the right ventricle horizontal path, the right ventricle anterior wall thickness, pulmonary main artery diameter, arterial systolic pressure and frequency spectrogram of tricuspid annulus at the right ventricle free wall were measured by TDI technique respectively, and the Tei index were calculated. Results Tei index of right ventricle in control group, IPF- I group, IPF- II group, and IPF- III group were 0.27 ± 0.11, 0.37 ± 0.10, 0.54 ± 0.13, and 0.70 ± 0.14; And there were significant differences among IPF- I group, IPF-II group, and IPF-m group （P 〈 0.05）, which were all different from that in control group （P 〈 0.05）. Conclusions The right cardiac function were damaged in patients with IPF with advanced stage because of fibrosis and PAH, and Tei index of right ventricle could estimate right ventricular function effectively.