超声心动图在肺动脉高压病变中的诊断价值研究

The value of echocardiography in the diagnosis of pulmonary hypertension

目的:探讨在肺动脉高压病变诊断中应用超声心动图的临床价值。方法:选取疑似肺动脉高压病变者87例为医学观察对象(病变组),入组患者均采取超声心动图及右心导管检查,以后者检查结果为“金标准”,分析超声心动图在肺动脉高压病变诊断中的准确度、特异度及敏感性。另选取同期来院体检健康人群60例作为健康组,均予以超声心动图检查。将检查结果与病变组相对照,分析肺动脉高压病变患者的超声心动图特征。结果:本研究87例疑似病例经右心导管检查,其中83例确诊为肺动脉高压病变;经超声心动图检查,82例诊断为肺动脉高压,其中假阳性1例,假阴性2例,诊断准确度96.6%,特异度75.0%,敏感度97.6%;超声心动图检查诊断肺动脉高压病变分类的准确率93.9%,与右心导管检查准确率之间差异无统计学意义(P>0.05);病变组的肺动脉压高于健康组,其肺动脉内径、右房纵径/横径、下腔静脉内径均长于健康组,右室壁厚度低于健康组,差异有统计学意义(P<0.01)。结论:在肺动脉高压病变诊断中应用超声心动图检查,诊断准确度及敏感度较高,同时超声心动图可清晰呈现肺动脉高压病变患者的肺动脉及心脏状况并与健康人群加以区分,且此检查方式简便、价廉、无创,有较高的临床诊断价值,值得推广应用。

Objective To explore the clinical value of echocardiography in the diagnosis of pulmonary hypertension.Method 87 patients with suspected pulmonary hypertension in our hospital were selected as medical observation objects(pathological group).All the patients were examined by echocardiography and right cardiac catheterization,the accuracy,specificity and sensitivity of echocardiography in the diagnosis of pulmonary hypertension were analyzed.In addition,60 healthy people who came to the hospital for physical examination in the same period were selected as the health group,all of them were examined by echocardiography.The echocardiographic characteristics of patients with pulmonary hypertension were analyzed.Results In this study,87 suspected cases were examined by right cardiac catheterization,83 of them were diagnosed as pulmonary hypertension.82 cases were diagnosed as pulmonary hypertension by echocardiography,including 1 false positive and 2 false negative.The accuracy,specificity and sensitivity were 96.6%,75.0%and 97.6%,respectively.The acculacy of echocardiography in the diagnosis of pulmonary hypertmension was 93.9%,there was no significant difference between the accuracy of echocardiography and right cardiac catheterization(P>0.05).The diameter of pulmonary artery,the longitudinal/transverse diameter of right atrium and the diameter of inferior vena cava in the pathological group were longer than those in the healthy group,and the thickness of right ventricular wall was lower than that in the healthy group(P<0.01).Conclusion The application of echocardiography in the diagnosis of pulmonary hypertension has high accuracy and sensitivity.At the same time,echocardiography can clearly show the pulmonary artery and heart status of patients with pulmonary hypertension and distinguish them from healthy people.Moreover,this method is simple,cheap,noninvasive,and has high clinical diagnostic value,which is worth popularizing and applying.