组织多普勒成像对阻塞性睡眠呼吸暂停综合征患者右心功能的评估价值

Analysis of right ventricular function in patients with obstructive sleep apnea hypopnea syndrome using tissue doppler image by echocardiography

目的应用组织多普勒(TDI)联合心肌功能指数(Tei指数)评价阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者早期右心功能改变,探讨不同病情OSAHS患者右心结构和功能的改变情况及其相关关系。方法经全夜多导睡眠监测仪确诊的OSAHS患者30例为实验组,根据是否伴有高血压分为单纯OSAHS组及OSAHS合并高血压(HT)组,选取正常对照组15例,对比三组超声常规及组织多普勒参数、睡眠呼吸紊乱等参数;根据OSAHS患者呼吸暂停低通气指数(AHI),分为正常对照组、轻度OSAHS组及中、重度OSAHS三组,对比三组组织多普勒参数及其关系。结果伴或不伴HT的OSAHS患者右室Tei指数与对照组比较显著增高;不同病情下,OSAHS患者右室Tei指数存在显著性差异,且随AHI升高逐渐升高。结论 Tei指数能够敏感反映OSAHS患者右心功能改变且与OSAHS病情程度相关联。

Objective To evaluate the early change of right ventricular function of patients with obstructive sleep apnea hypopnea syndrome（OSAHS） using myocardial performance index（MPI/Tei index） by tissue doppler image（TDI） of echocardiography,and to investigate the change of right ventricular function and structure of patients with OSAHS in different conditions.Methods 15 controls and 30 patients of OSAHS diagnosed by polysmnography（PSG）,divided the patients of OSAHS into simple OSAHS group and OSAHS with hypertension（HT） group.All the echocardiographic datasets were acquired by Philips iE33 medical system,the series of RV echocardiograhpic parameters,namely Tei Index,were offline measured by RV-analysis software by TDI system and the series of OSAHS dates of apnea and hypopnea index（AHI） were acquired by Neurotronics PSG.Further,divided all the enrollment subject into normal group,mild group of OSAHS and moderate-severe group of OSAHS according to the condition of AHI.Contrasted all the parameters and found out the relation between.Results Compared to normal control group,the Tei index in patients of OSAHS was significantly higher（P0.05） irrespective of HT.Further,the Tei index determined by TDI correlated closely with AHI.Conclusion TDI combined with Tei index could conveniently,accurately measure the change of RV function of patients with OSAHS.Tei index could be a useful parameter to evaluate RV dysfunction.