乙肝肝硬化患者右心房功能变化的超声评估分析

Ultrasonographic Evaluation Analysis of Right Atrial Function in Patients with Hepatitis B Cirrhosis

目的分析超声对乙肝肝硬化患者右心房功能变化的评估价值。方法选取我院60例乙肝肝硬化患者和50例同期健康体检者为研究对象,根据肝功能分级将患者分为A组(29例)、B组(23例)、C组(8例),均行常规连接心动图下超声检查。比较两组右心房功能指标的差异,主要包括右心腔结构、右心舒张功能及右心收缩功能。结果与对照组相比,A、B、C三组右房长径、右室舒张末期前后径、右室前壁厚度显著增大(P<0.05);但右室内、外侧壁舒张早期波峰值与组织舒张晚期波峰值之比、舒张期血流E峰与A峰比值之比(E/A)均显著较小(P<0.05);3组三尖瓣内侧、外侧壁舒张早期波峰值、右心室面积变化率、右心室心肌机能指数均显著较低(P<0.05)。结论超声检查显示乙肝肝硬化患者心脏增大,右室整体收缩、舒张功能减低,且肝功能越差者其超声表现越明显。

Objective This study aimed to analyze the value of ultrasound in evaluating right atrial function in patients with hepatitis B cirrhosis.Methods A total of60patients with hepatitis B cirrhosis and the same period of50healthy people in our hospital were enrolled in the study.According to the liver function grade,the patients were divided into group A(n=29),group B(n=23)and group C(n=8),and healthy people were grouped into the control group(n=50).All the participants underwent routine echocardiography under ultrasound.The indexes of right atrial function were compared between the two groups,including right ventricular structure and right heart systolic function.Results Compared with the control group,RVd and RVAW in group A,B and C were significantly higher(P<0.05),while Em/Am of right ventricular inside and outside walls and E/A were significantly smaller(P<0.05)than that of control group.RALd,RVd,RVAW,Em/Am of right ventricular inside and outside walls and E/A,Em of tricuspid inside and outside annular planes showed significant differences between group A and group C,RALd of group B and C also showed significant statistical differences(P<0.05).Conclusion Ultrasound examination showed that the heart of patients with hepatitis B cirrhosis increased,the overall right ventricular systolic and diastolic function decreased,and the ultrasonic phenomenons were more obvious in patients with poor liver function.