慢性阻塞性肺疾病患者心脏状况的超声心动图研究

Echocardiographic study of cardiac status in patients with chronic obstructive pulmonary disease

目的 探讨超声心动图在慢性阻塞性肺疾病（COPD）患者心脏状况中的评估作用.方法 选取2014年2月至2016年2月COPD患者168例作为研究组,另选取45例同期进行健康体检者作为对照组,比较两组观察对象的左心系统、右心系统、左心系统心肌纵向应变值和右心系统心肌纵向应变值.将COPD患者分为轻度、中度和重度三组,比较三组患者的左心系统、右心系统、左心系统心肌纵向应变值和右心系统心肌纵向应变值.结果 研究组左心房内径、肺动脉收缩压显著高于对照组,研究组左心室短轴缩短率、左心室射血分数、右心室射血分数、右心室面积变化分数显著低于对照组,研究组左心室整体纵向应变值、右心室整体纵向应变值显著低于对照组,差异有统计学意义（P〈0.05）.轻度、中度和重度COPD患者左心房内径、肺动脉收缩压、左心室短轴缩短率、左心室射血分数、右心室射血分数、右心室面积变化分数均随病情的严重程度逐渐改变,差异有统计学意义（P〈0.05）;轻度、中度和重度COPD患者左心室整体纵向应变值、右心室整体纵向应变值均随病情的严重程度逐渐改变,差异有统计学意义（P〈0.05）.结论 通过超声心动图对慢性阻塞性肺疾病患者的心脏状况研究,随着慢性阻塞性肺疾病的严重程度,患者左右心室的功能也逐渐下降,在轻度和中度患者中也有较好的表现,是识别早期慢性阻塞性肺疾病患者的检测手段,值得临床推广.

Objective To investigate the evaluation effect of echocardiography for cardiac status in patients with chronic obstructive pulmonary disease （COPD）.Methods A total of 168 patients with COPD from February 2014 to February 2016 were selected as the study group, the other 45 cases of health examination in the same period were selected as the control group.The left heart system, the right heart system and the value of left heart myocardial longitudinal strain and right heart myocardial longitudinal strain were compared.The COPD patients were divided into mild group, moderate group and severe group, the left heart, right heart, the value of left heart myocardial longitudinal stain and right heart myocardial longitudinal strain of the three groups were compared.Results In the study group, the left atrial diameter, pulmonary artery systolic pressure were higher than those in the control group;the left ventricular fractional shortening of left ventricular ejection fraction, right ventricular ejection fraction, right ventricular surface change were lower than those in the control group;the volume change scores were significantly lower than those in the control group;the left ventricular longitudinal strain, right ventricular longitudinal strain were significantly lower than those in the control group, and the differences were significant（P〈0.05）.In the mild, moderate and severe COPD group, the left atrial diameter, pulmonary artery systolic pressure, left ventricular short shortening, left ventricular ejection fraction, right ventricular fractional area change with the severity of the disease was gradually changed（P〈0.05）.The left ventricular longitudinal strain, right ventricular longitudinal strain with the severity of the disease was gradually changed, the differences were significant（P〈0.05）.Conclusions The state of heart function of patients with chronic obstructive pulmonary disease detected by echocardiography shows, with the severity of chronic obstructive pulmonary disease, the function of the patient＆#39;s left and right ventricle is gradually declining, and there is good performance in mild and moderate COPD patients.It is a way to identify patients with early chronic obstructive pulmonary disease, and it is worthy of clinical application.