尘肺患者右心室收缩功能的三尖瓣环收缩期位移评价

Right ventricular systolic function of patients with pneumoconiosis based on the evaluation of systolic displacement of tricuspid annulus

目的 用M型超声心动图技术测量三尖瓣环收缩期位移（TAPSE）,评价尘肺患者右心室收缩功能.方法 尘肺组病例183例,正常健康对照组199例;根据肺功能通气损害的性质分为正常型、阻塞型、限制型、混合型4组.取心尖四腔切面,用M型超声心动图测量三尖瓣环右心室游离壁侧从舒张期至收缩末期的位移.结果 尘肺组TAPSE均值为（18.61±3.08） mm,对照组TAPSE均值为（22.38±3.03） mm,尘肺组TAPSE明显低于对照组,差异有统计学意义（P＜0.01）.随Ⅰ、Ⅱ、Ⅲ期尘肺病变程度的加重TAPSE明显缩短,与对照组比较,差异有统计学意义（P＜0.01）.肺功能检测为正常型、阻塞型、限制型、混合型肺功能损伤尘肺患者的TAPSE均明显低于对照组,其中以混合型缩短最明显,差异均有统计学意义（P＜0.01）.结论 尘肺患者TAPSE值明显缩短,随尘肺分期加重而明显缩短,TAPSE的测量评价尘肺患者右心室收缩功能状态简便方法.

Objective To determine the tricuspid annular plane systolic excursion （TAPSE） using M-mode echocardiography,and to evaluate the right ventricular systolic function in patients with pneumoconiosis.Methods One hundred and eighty-three patients with pneumoconiosis were enrolled as subjects,and one hundred and ninety-nine healthy volunteers were used as controls.According to the types of ventilation dysfunction,patients were divided into four groups：normal type,obstructive type,restrictive type,and mixed type.In the apex four-chamber sections,the displacement of tricuspid annular plane on the right ventricular free wall side was measured from end-diastole to end-systole using M-mode echocardiography.Results The average TAPSE in the pneumoconiosis group was significantly lower than that in the control group （18.61±3.08 vs 22.38±3.03 mm,P＜0.01）.Along with the progression of pneumoconiosis,the TAPSE values in patients with stage Ⅰ,Ⅱ,and Ⅲ pneumoconiosis were significantly decreased compared with those in the control group （P＜ 0.01）.The TAPSE values in patients diagnosed with normal,obstructive,restrictive,and mixed types of pneumoconiosis in pulmonary function tests were all significantly lower than those in the control group （P＜ 0.01）.Among all patients,patients with mixed type of pneumoconiosis had the most significant reduction in the TAPSE.Conclusion The TAPSE is substantially decreased in patients with pneumoconiosis and further decreased along with the progression of pneumoconiosis.Measurement of the TAPSE is an easy way to evaluate the right ventricular systolic function in patients with pneumoconiosis.