TDI-Tei指数对CHD患者右心室功能的评价研究

Study on TDI-Tei index in evaluating right ventricular function in patients with congenital heart disease

目的分析TDI-Tei指数评价先天性心脏病(CHD)患者右心室功能的临床价值及意义。方法选取2014年1月—2016年12月在温州市妇幼保健院接受治疗的62例CHD患者为患病组根据是否合并PAH分为两组,35例未合并PAH患者列为CHD组,27例合并PAH患者列为PAH组,同时选取58例正常健康儿童作为对照组。检测三组研究对象的TDI-Tei指数与PWD-Tei指数值,并进行对比分析。结果 PAH组的右心室TDI-Tei指数、PWD-Tei指数均显著高于对照组(t_(TDI-Tei)=17.34t_(PWD-Tei)=20.66,均P<0.05)及CHD组(t_(TDI-Tei)=10.41,t_(PWD-Tei)=18.73,均P<0.05),而CHD组仅右心室TDL-Tei指数数值大于对照组,差异具有统计学意义(t=4.99,P<0.05);患病组TDI-Tei指数及PWD-Tei指数均与PASP呈正相关,并且TDI-Tei指数与PASP(r=0.762,P<0.001)的相关性较PWD-Tei指数与PASP(r=0.613,P<0.001)的相关性更好;TDI-Tei指数取0.45截点值时对CHD合并PAH诊断的灵敏度为79.81%,特异度为91.22%,其诊断价值高于PWD-Tei指数。结论右心室TDI-Tei指数可有效评价CHD患者右心室功能,对是否合并PAH的评估价值较高,同时对CHD患者病情评估及辅助治疗具有重要的临床意义。

Objective To study the clinical value and significance of TDI-Tei index in evaluating right ventricular function in patients with congenital heart disease（CHD）. Methods From January 2014 to December 2016,62 cases of CHD accepting treatment in Maternal and Child Health Hospital of Wenzhou City were selected as case group,and they were divided into two groups according to whether complicated with pulmonary artery hypertension（PAH）,35 cases without PAH in CHD group and 27 cases of patients with PAH in PAH group. Fifty-eight healthy people were selected as control group. The TDI-Tei index and PWD-Tei index value of three groups were detected and compared. Results TDI-Tei index and PWD-Tei index of right ventricle in PAH group were significantly higher than the control group（tTDI-Tei= 17. 34,tPWD-Tei= 20. 66,P〈0. 05） and CHD group（tTDI-Tei= 10. 41,tPWD-Tei= 18. 73,P〈0. 05）,and in CHD group only TDL-Tei index of right ventricle was greater than the control group with statistical significance（t = 4. 99,P〈0. 05）. TDI-Tei and PWD-Tei index were positively correlated with pulmonary artery systolic pressure（PASP） in case group,and the correlation between TDI-Tei index and PASP was greater than that between PWD-Tei index and PASP（r = 0. 613,P〈0. 001）. The ROC curve showed that the sensitivity of TDI-Tei index in diagnosis of CHD combined with PAH was 79. 81% and specificity was 91. 22% when the cut-off value was 0. 45,and the diagnostic value was higher than that of PWD-Tei index. Conclusion TDI-Tei index can effectively evaluate right ventricular function of patients with CHD,and is valuable to assess whether PAH is complicated. TDI-Tei index has important clinical significance for CHD patient assessment and treatment.