Tei指数评价慢性阻塞性肺病肺动脉高压患者右心室功能的研究

Application of Tei-index in assessment of right-ventricular function for chronic obstructive pulmonary disease patients with pulmonary arterial hypertension

目的应用Tei指数评价慢性阻塞性肺病(COPD)伴肺动脉高压(PH)患者右心室功能的价值,并探讨Tei指数与肺动脉压的关系。方法临床确诊的COPD伴PH患者74例,根据三尖瓣反流压差估测肺动脉收缩压,并按其轻、中、重度分3组,轻度24例,中度29例,重度21例;正常27例为对照组。常规测量右心室前后径,肺动脉主干内径。利用多普勒技术测量三尖瓣E峰与A峰峰值速度、右心室等容收缩时间(ICT)与右心室等容舒张时间(IRT)、右心室射血时间(RVET),测算右心室Tei指数进行分析比较。结果 COPD伴PH患者轻、中、重度组右心室Tei指数(分别为0.38±0.05、0.45±0.04、0.59±0.06)均高于对照组(0.37±0.06)(均P<0.05),其升高程度与肺动脉收缩压均呈正相关(r=0.58、0.71、0.81,均P<0 05)。结论利用多普勒技术测算右心室Tei指数可较快速准确地评估COPD伴PH患者右心室整体舒张及收缩功能受损。

Objective To evaluate the application of Tei-index in assessment of right-ventricular function in chronic ob- structive pulmonary disease （COPD） patients with pulmonary arterial hypertension. Methods Seventy four C^PD patients with pulmonary arterial hypertension, including 24 cases of mild pulmonary arterial hypertension, 29 cases of moderate pulmonary ar- terial hypertension and 21 cases of severe pulmonary arterial hypertension were enrolled in the study; and 27 healthy subjects served as controls. The tricuspid regurgitation pressure, right ventricular diameter and pulmonary artery diameter were measured. The peak velocity of tricuspid E peak and A peak, right ventricular isovolumetric relaxation time （IRT）, right ventricular isovolu- metric contraction time （ICT） and right ventricular ejection time （RVET） were detected by Doppler technique; then the right ven- tricular Tel-index was calculated. Results Compared with normal subjects, The right ventricular Tei-index was higher in COPD patients with pulmonary arterial hypertension （mild, moderate and severe） （P〈0.05）. The degree of right ventricular Tei-index rise was positively correlated with pulmonary arterial hypertension （r=0.58,0.71,0.81,P〈0.05）. Conclusion The right ventricular Tei-index can accurately assess the impaired right ventricular diastolic and systolic function in the COPD patients with pulmonary arterial hypertension.