实时三维超声评价肺动脉高压患者右心室功能分析

Evaluation of right heart function in patients with pulmonary hypertension by real-time three-dimensional ultrasound

目的探讨实时三维超声心动图(RT-3DE)评价肺动脉高压患者右心室功能的临床价值。方法选择2016年1月‐2017年10月该院收治的50例原发性肺动脉高压患者,根据肺动脉收缩压分为轻度(21例)、中度(18例)、重度(11例)。所有患者均RT-3DE检查和磁共振成像(MRI)检查。RT-3DE采用全容积显像方式采集图像数据并应用4D RV-function软件进行右心室三维建模和心功能测量,获取收缩末期容积(ESV)、舒张末期容积(EDV)、每搏输出量(SV)、射血分数(RVEF)等心功能参数。与MRI检查结果进行对比并进行Pearson相关分析。结果轻度和中度肺动脉高压患者RT-3DE和MRI检查ESV、EDV、SV、RVEF测量值差异均无统计学意义(P>0.05);重肺动脉高压患者RT-3DE检查ESV为(81.64±8.85)ml,MRI检查为(86.32±7.58)ml,比较差异有统计学意义(P<0.05);RT-3DE检查EDV为(130.03±11.22)ml,MRI检查为(142.85±17.64)ml,比较差异有统计学意义(P<0.05)。结论 RT-3DE可实时、准确地定量评估原发性肺动脉高压患者右心室功能,具有很高的临床应用价值。

【Objective】To evaluate the clinical value of real-time three-dimensional echocardiography（RT-3 DE） in evaluating right ventricular function in patients with pulmonary hypertension.【Methods】Fifty patients with primary pulmonary hypertension admitted in our hospital from January 2016 to October 2017 were selected, and divided into mild group（21 cases）, moderate group（18 cases） and severe group（11 cases） according to pulmonary artery systolic pressure. All patients were examined by real time threedimensional echocardiography and magnetic resonance imaging（MRI）. RT-3 DE used a full volume imaging mode to collect the image data and 4 D RV-function software for three-dimensional modeling of right ventricle and cardiac function measurement, and heart function parameters such as the end systolic volume（ESV）, end diastolic volume（EDV）, stroke volume（SV）, right ventricular ejection fractions（RVEF） were obtained. Those results were compared with the results of magnetic resonance imaging（MRI）, and the Pearson related analysis was carried out.【Results】In mild and moderate pulmonary hypertension patients examined by RT-3 DE or MRI, EDV, SV, ESV RVEF measurements showed no significant difference（P〉0.05）; for severe pulmonary hypertension patients, ESV was（81.64 ± 8.85） ml in RT-3 DE and（86.32 ± 7.58） ml in MRI, the difference was statistically significant（P〈0.05）; EDV was（130.03 ± 11.22） ml in RT-3 DE and（142.85 ± 17.64） ml in MRI, the difference was statistically significant（P〈0.05）. 【Conclusions】The real-time three-dimensional echocardiography can quantitatively and accurately evaluate right ventricular function of primary pulmonary hypertension patients in real time, which has a high clinical application value.