超声心动图对重度三尖瓣反流患者右室收缩功能的评价

Echocardiographic Evaluation of Right Ventricular Systolic Function in Patients with Severe Tricuspid Regurgitation

目的:利用超声测量各种参数对重度三尖瓣反流患者的右室收缩功能进行评估。材料与方法:行超声心动图检查的102名重度三尖瓣反流患者,根据压差计算分肺动脉高压轻度、中度、重度三组,另选取30名健康体检者作为对照组。分别测量右房、右室左右径,M型超声测量三尖瓣环收缩期位移(TAPSE),组织多普勒测量三尖瓣环收缩期S波峰值速度(S’),并计算心肌综合指数(MPI)。结果:轻度组S’和对照组相比较,差异有统计学意义(p<0.01);中度组和重度组在TAPSE、MPI和S’等参数和对照组相比较,差异均有统计学意义(p<0.01)。结论:重度三尖瓣反流患者可合并不同程度的肺动脉高压,利用TAPSE、S’、MPI评价右室收缩功能有意义,动态分析这些参数的变化可对患者病情的诊疗进行评估。

Objective:To evaluate right ventricular systolic function in patients with severe tricuspid valve stenosis by measuring various parameters with echocardiography. Materials and Methods:One hundred and two patients with severe tricuspid regurgitation who underwent echocardiography were divided into three groups according to the pressure gradient: mild, moderate, and severe pulmonary hypertension, and another 30 healthy subjects were selected as the control group. Right atrial and right ventricular left and right diameters were measured, tricuspid annular systolic displacement(TAPSE) was measured by M-mode ultrasound, tricuspid annular peak systolic S wave velocity(S ’) was measured by tissue Doppler, and myocardial performance index(MPI) was calculated. Results:There were significant differences between the mild group and the control group(P<0.01), and there were significant differences in TAPSE, MPI and S ’between the moderate group and the control group(P<0.01). Conclusion:Patients with severe tricuspid valve can be complicated with different degrees of pulmonary hypertension. It is significant to evaluate right ventricular systolic function by TAPSE, S ’and MPI. Dynamic analysis of the changes of these parameters can evaluate the diagnosis and treatment of patients.