彩色多谱勒超声与数字平板影像对慢性阻塞性肺病急性加重患者右心室功能临床评估

Value of Color Doppler Ultrasonic and Digital X-ray in Estimating Right Ventricular Function of Patients with AECOPD

目的探讨心脏彩色多谱勒超声与数字平板影像在对慢性阻塞性肺病急性加重患者右心功能评估中的价值.方法 2013年9月31日至2014年5月31日,因慢性阻塞性肺病急性加重入住昆明市第一人民医院呼吸内科的COPD患者.同意行血气检查的患者共31例,其中同时完成血气分析检查及胸部数字平板检查共25例,完成血气分析检查及心脏彩超检查患者18例.描述性统计结果采用均数±标准差,数据组间分析采用单因素方差分析.结果伴有低氧血症的AECOPD患者肺动脉及右心室影像有改变,但右下肺动脉横径、肺动脉突出高度、右心室高度与患者动脉血氧分析(Pa O2)之间没有相关性.心脏彩色多谱勒超声结果显示:右心室内径和右室流出道内径会随Pa O2增高而降低.结论心脏彩色多谱勒超声右室参数的改变与患者血气分析有一定的关联,患者右心室内径及右室流出道随血氧分压升高有下降趋势.数字平板影像右室相关参数与血气分析结果中Pa O2无明显关联.

Objective To study the value of cardiac color Doppler ultrasonic and digital X-ray in estimating right ventricular function of patients with AECOPD.Methods From September 31th,2013 to April 31th,the patients were admitted in our department because of acute exacerbation of chronic obstructive pulmonary disease （AECOPD）.There were 31 patients tested with blood and gas analysis,and 25 patients agreed testing with digital X-ray and blood and gas analysis.18 patients accepted cardiac color Doppler ultrasonic and blood and gas analysis.Mean ± standard deviation was used in descriptive statistical analysis.Independent samples T test was used to analyze the difference between groups.Results The image of digital X-ray of pulmonary artery and right ventricular sinister had changes in patients with AECOPD and hypoxemia.There was no association between hypoxemia and the lower right pulmonary artery transverse diameter,pulmonary artery prominent height,right ventricular height.The cardiac color Doppler ultrasonic showed that the inner diameter of right ventriculus sinister and outflow tract of right ventricle would become narrow followed raise of partial pressure of blood oxygen （PaO2） Conclusions There is no relation between relative parameter of right ventricle of digital X-ray image and PaO2.There is somehow relation between parameters of right ventricle of Color Doppler Ultrasonic and blood and gas analysis.There is decreaed tendency between PaO2 and inner diameter of right ventriculus sinister and outflow tract of right ventricle.