三维超声心动图对中重度肺动脉高压患者射血分数与右室容积评估应用价值分析

Application value of three-dimensional echocardiography to reviews of ejection fraction and right ventricular volume in patients with moderate-severe pulmonary arterial hypertension

目的分析实时三维超声心动图(RT-3DE)对中重度肺动脉高压(PAH)患者射血分数与右室容积评估应用价值。方法选取2016年9月至2018年1月于内蒙古自治区人民医院和内蒙古医科大学附属医院接受治疗PAH中度及重度患者各50例,同时选取同时间段在内蒙古自治区人民医院和内蒙古医科大学附属医院体检健康者50例作为对照组,RT-3DE检测右室射血分数(RVEF)、右室舒张末期容积(RVEDV)、右室每搏输出量(RVSV)及右室收缩末期容积(RVESV),常规超声心动图检测右室面积变化分数(RVFAC)、三尖瓣环收缩期峰值速度(S’)、三尖瓣环收缩期位移(TAPSE)、右室心肌做功指数(RIMP)、右室游离壁厚度(RV-FW)、右心房左右径(RA-D1)、右心室基底部左右径(RV-D)及右心房上下径(RA-D2),并分析肺动脉收缩压(PASP)和各参数间相关性状况。结果中度、重度组患者RC-FW、RA-D1、RA-D2及重度组RV-D均高于对照组,重度组RA-D1、RA-D及RA-D2高于中度组,差异均有统计学意义(P<0.05);中度、重度组RVEF低于对照组,RVEDV、RVESV及重度组RVSV高于对照组,重度组RVEF低于中度组,RVEDV及RVESV高于中度组,差异均有统计学意义(P<0.05);中度、重度组RVFAC、TAPSE及重度组S’低于对照组,RIMP高于对照组,重度组RVFAC、TAPSE低于中度组,差异均有统计学意义(P<0.05)。结论 RT-3DE技术能够准确、客观对中度及重度PAH患者射血分数与右室容积做出评价,为临床患者诊疗提供参考。

Objective To analyze the application value of real-time three-dimensional echocardiography(RT-3DE)to reviews of ejection fraction and right ventricular volume in patients with moderate-severe pulmonary arterial hypertension(PAH).Methods PAH patients received treatment were chosen from People’s Hospital of Inner Mongolia Autonomous Region and Affiliated Hospital of Inner Mongolia Medical University,from Sept.2016 to Jan.2018,and divided into moderate PAH group and severe PAH group(each n=50).At the same time the healthy controls(n=50)were chosen into control group.The indexes of right ventricular ejection fraction(RVEF),right ventricular end-diastolic volume(RVEDV),right ventricular stroke volume(RVSV)and right ventricular endsystolic volume(RVESV)were detected by using RT-3DE.The indexes of right ventricular fractional area change(RVFAC),tricuspid annulus peak systolic velocity(S’),tricuspid annulus plane systolic excursion(TAPSE),right ventricular index of myocardial performance(RIMP),right ventricular free wall thickness(RV-FW),right atrial left and right diameter(RA-D1),right ventricular basal diameter(RV-D)and right atrial upper and lower diameter(RA-D2)were detected by using conventional echocardiography.The correlation among pulmonary arterial systolic pressure(PASP)and all above indexes was analyzed.Results RC-FW,RA-D1 and RA-D2 in moderate PAH group and severe PAH group and RV-D in severe PAH group were higher than those in control group,and RA-D1,RA-D and RA-D2 were higher in severe PAH group than those in moderate PAH group(P<0.05).RVEF was lower in moderate PAH group and severe PAH group than those in control group,RVEDV and RVESV in moderate PAH group and severe PAH group and RVSV in severe PAH group were higher than those in control group,RVEF was lower and RVEDV and RVESV were higher in severe PAH group than those in moderate PAH group(P<0.05).RVFAC and TAPSE in moderate PAH group and severe PAH group and S’in severe PAH group were lower,and RIMP was higher than those in control group,and RVFAC and TAPSE were lower in severe PAH group than those in moderate PAH group(P<0.05).Conclusion RT-3DE can accurately and objectively review the ejection fraction and right ventricular volume in patients with moderate-severe PAH,and provide a reference for clinical diagnosis and treatment.