超声心动图诊断肺动脉高压157例分析

Analysis of echocardiography in the diagnosis of 157 patients with pulmonary hypertension

目的探讨超声心动图诊断肺动脉高压(PH)的临床价值。方法对157例确诊为PH患者给予超声心动图及CT、X线、肺动脉造影等检查,部分给予右心导管测量肺动脉收缩压(PASP),并与超声心动图测量肺动脉压值进行对比分析。结果本组157例患者中,经超声心动图确诊患者148例,确诊率94.3%。结合其他检查全部确诊。超声心动图误诊的9例中,6例为右肺动脉狭窄,3例为左肺动脉狭窄。肺动脉高压患者超声心动图检查主要表现为右心室肥厚增大,右心房扩大,肺动脉增宽,收缩期三尖瓣可见反流,反流频谱呈高速。30例患者右心导管测量PASP与超声心动图测量比较,差异无统计学意义(P>0.05)。结论超声心动图诊断PH具有准确率高、方便快捷、无创性、可重复性高等特点,且对病因的明确具有重要意义。

Objective To discuss the clinical value of echocardiography in the diagnosis of patients with pulmonary hypertension （PH）. Methods 157 patients confirmed with pulmonary hypertension were tested with echocardiography diagram and CT, X-line, and pulmonary angiography. Part of the patients were given the fight heart catheter measurement of pulmonary artery pressure, and were con- trasted with echocardiographic measurements. Results There were 148 patients confirmed with PH by cchoeardiographic, and the diag- nostic rate was 94. 3%. The remaining patients were confirmed by the combination with other tests. There were 9 misdiagnosed cases, in- cluding 6 cases of right pulmonary artery stenosis and 3 cases of left pulmonary artery stenosis. The main expressions of PH patients includ- ed right ventricular hypertrophy, right atrial enlargement, pulmonary widened, and systolic tricuspid high-speed reflux. There was no sig- nificantly difference on PASP between right heart catheter measurement and echocardiography （ P 〉 0.05 ）. Conclusion Echocardio- graphy has the advantages of high accuracy, convenience, non-invasive, and high repeatability in the diagnosis of patients with PH, and has great significance in the final diagnosis of the cause.