组织多普勒成像TDI-Tei指数联合TDI-Z指数评价慢性阻塞性肺疾病右心室功能

Evaluation of right ventricular function in patients with chronic obstructive pulmonary disease by tissue doppler imaging TDI-Tei index and TDI-Z index

目的探讨组织多普勒成像TDI-Tei指数联合TDI-Z指数评价慢性阻塞性肺疾病(COPD)右心室功能的价值。方法对106例COPD患者(根据肺动脉收缩压分为Ⅰ、Ⅱ、Ⅲ、Ⅳ组)及36例健康人群(对照组)行组织多普勒及常规超声心动图检查和肺功能测量,计算右心室TDI-Tei指数及TDI-Z指数,并比较联合检查的准确性。结果 COPD患者各组的SPAP、RAD、RVD、RVWT、MPA均随SPAP增高而增高(P<0.05),呈现出明显的右房右室增大,右室壁增厚,肺动脉主干内径增宽;Ⅰ、Ⅱ、Ⅲ及Ⅳ组的Tei指数明显增高,TDI-Z指数明显减低,且随SPAP增高而更显著(P<0.05),且其Tei指数及TDI-Z指数与FEV1/FVC有明显相关性;Tei指数联合TDI-Z指数评价COPD患者右心室功能降低的阳性率高于应用单一方法 (P<0.05)。结论 TDI-Tei指数及TDI-Z指数联合应用可无创、有效、定量评价COPD患者右心室功能。

Obective To evaluate the value of right ventricular function in patients with chronic obstructive pulmonary disease （COPD） by tissue doppler imaging TDI-Tei index and TDI-Z index. Methods One hundred and six cases of COPD patients were divided into group I, II, III and IV according to the pulmonary artery systolic pressure and 36 healthy subjects who were selected as the control group, all the subjects accepted tissue doppler imaging, conventional echocardiography and lung function measurement. The right ventricular TDI-Tei index and TDI-Z index were calculated, and the ac curacy of joint examination were compared. Results The levels of SPAP, RAD, RVD, RVWT and MPA in COPD groups were increased with the increase of SPAP （P〈0.05）, and they showed marked enlargement of the right atrium, right ventricle, thickening of the right ventricular wall, and widening of the internal diameter of the main pulmonary artery. The Tei index in groupⅠ、Ⅱ、Ⅲ and Ⅳ group were significantly increased, and the TDI-Z index were decreased, with the increase of SPAP, they were more significant （P〈0.05）. The Tei index and TDI-Z index were significantly related to FEV1/FVC. The positive rate of Tei index combined TDI-Z index in right ventricular dysfunction in COPD patients was higher than that of single method （P〈0.05）. Conclusion Combined use of TDI-Tei index and TDI-Z index is noninvasive, effective and quantitative evaluation of right ventricular function in COPD patients.