超声心动图评价不同危险程度急性肺栓塞患者左心室功能

Evaluation of left ventricular function by echocardiography in patients with acute pulmonary embolism

目的探讨超声心动图评价不同危险程度急性肺栓塞(APE)患者左心室功能的临床价值。方法选取2017年3月~2018年7月承德医学院附属医院就诊的94例APE患者为研究对象,APE患者为APE组,再将患者进行危险程度分级并分成低危者(n=35)、中危者(n=31)和高危者(n=28),并选取同期健康体检者50名为对照组。对比分析两组超声心动图测值[心率(HR)、右室舒张末内径与左室舒张末内径之比(RVED/LVED)、肺动脉收缩压(PASP)、左室舒张末容积(LVEDV)、左室收缩末容积(LVESV)、左室每博量(LVSV)、左室射血分数(LVEF)]的差异。结果APE组较对照组HR、RVED/LVED、PASP水平明显增高,且随着危险分级提高,HR、RVED/LVED、PASP亦呈增高趋势(均P<0.05)。APE组较对照组LVEDV、LVESV、LVSV水平明显降低,且随着危险分级逐渐提高,LVEDV、LVESV、LVSV水平呈降低趋势(均P<0.05)。APE组与对照组LVEF比较,差异无统计学意义(P>0.05)。结论APE患者存在不同程度左心功能损害,超声心动图可有效评估左心功能变化,对早期病情诊断有重要意义。

Objective To investigate the clinical value of echocardiography in evaluating left ventricular function in patients with acute pulmonary embolism(APE) of different risk levels. Methods 94 APE patients(35 in low-risk group, 31 in medium-risk group and 28 in high-risk group) were selected and 50 healthy people in the same period were selected as the control group. The echocardiographic values(HR), the ratio of right ventricular end diastolic diameter to left ventricular end diastolic diameter(RVED/LVED), pulmonary artery systolic pressure(PASP), left ventricular end diastolic volume(LVEDV), left ventricular end diastolic volume(LVSV) were compared and analyzed. Results The levels of HR, RVED/LVED and PASP in APE group were significantly higher than those in control group(P<0.05), and HR, RVED/LVED and PASP were all increased with the increase of risk classification(P<0.05). Compared with the control group, the level of LVEDV, LVESV and LVESV in APE group was significantly lower(P<0.05), and the level of LVEDV, LVESV and LVSV decreased with the increase of risk classification(P<0.05). There was no significant difference in LVEF between APE group and control group(P>0.05). Conclusion APE patients have different degrees of left heart function damage, echocardiography can effectively evaluate the change of left heart function, which is of great significance for the early diagnosis of the disease.