超声心动图在慢性阻塞性肺疾病患者右心收缩功能中的评估价值

Right ventricular systolic function in patients with COPD by echocardiography

目的:探讨超声心动图在评估慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者右心收缩功能中的临床价值。方法:选取2012年6月至2014年6月因COPD在我院诊治的患者56例设为COPD组及同期在我院体检的健康者53例设为对照组,通过超声心动图的表现情况分析两组间右心收缩功能。结果:COPD组右心房上下径、右心房左右径、右心房面积及右心室流出道近端(right ventricular outflow tract,RVOT)内径均大于对照组,差异有统计学意义(P<0.05);COPD组右心室侧壁厚度(right ventricular wall thickness,RVWT)厚于对照组,差异有统计学意义(P<0.05);COPD组的右房室瓣环收缩期位移(tricuspid annular planesystolic excursion,TAPSE)低于对照组,差异有统计学意义(P<0.05);COPD组的右心室心肌做功指数(right ventricular myocardial performance index,RV-MPI)、右心室侧壁基底段纵向应变(longitudinal strain of right ventricular lateral wall basal seg-ment,RV-strain)均高于对照组,差异有统计学意义(P<0.05)。结论:超声心动图可用于评估COPD患者的右心收缩功能及右心腔结构,COPD患者现为右心腔增大,右心收缩功能不同程度受损,该方法可用于早期诊断COPD。

Objective：To investigate the value of right ventricular systolic function in patients with chronic obstructive pulmona-ry disease（ COPD） by echocardiography. Methods：56 patients with COPD and 53 healthy individuals in our hospital from June 2012 to June 2014 were chosen,respectively divided into COPD group and the control group. Right ventricular systolic function and structures were analyzed between the two groups by the performance of echocardiography. Results：The RA-1,RA-2,RA-3 and right ventricular outflow tract（RVOT）inner diameter in the COPD group were higher than those in the control group（P〈0. 05）;The right ventricular wall thickness（RVWT）in the COPD group was wider than that in the control group（P〈0. 05）;The tricuspid annular planesystolic ex-cursion（TAPSE）in the COPD group was lower than that in the control group（P〈0. 05）;The right ventricular myocardial performance index（ RV-MPI） and longitudinal strain of right ventricular lateral wall basal segment（ RV-strain） in the COPD group were higher than those in the control group（P〈0. 05）. Conclusion：The echocardiography can assess the systolic function and structure of right heart quantitatively. Right heart size of COPD patients is greater, and systolic and diastolic function has decreased. Therefore, echocardio-graphy can be used for early diagnosis of COPD.