Tei指数评价慢性阻塞性肺疾病伴肺动脉高压患者右心功能的意义

The significance of Tei index in evaluating the right heart function in patients with chronic obstruction pulmonary disease complicated by pulmonary hypertension

目的探讨应用Tei指数评价慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)伴肺动脉高压(pulmonary hypertension,PH)患者右心功能的价值,并且讨论Tei指数与6 min步行距离(6MWD)、肺动脉收缩压(PASP)之间的相关性。方法选取2017年5月至2019年4月就诊的COPD伴HP患者62例、同期健康体检者20例作为对照组。根据超声测量PASP数值分为重度PH组14例、中度PH组22例和轻度PH组26例。对受试者测得右心室Tei指数、6MWD、红细胞分布宽度(red blood cell distribution width,RDW),分析Tei指数与6MWD、PASP之间的相关性。结果COPD伴HP各组Tei指数及RDW均高于对照组,差异均有统计学意义(P<0.05)。Tei指数随着PH压力升高而升高,轻中重PH组两两比较Tei指数差异均有统计学意义(P<0.05)。RDW随着PH压力升高而升高,重度与轻度PH组相比RDW差异有统计学意义(P<0.05);Tei指数与6MWD相关性分析显示两者呈负相关(r为-0.753,P<0.05)。Tei指数与PASP进行相关性分析显示呈正相关(r为0.884,P<0.05)。结论右心室Tei指数可作为COPD伴PH患者右心功能早期评价的参考指标。

Objective To investigate the significance of Tei index in evaluating the right heart function in patients with chronic obstruction pulmonary disease(COPD)complicated by pulmonary hypertension(PH),and to explore the correlation between Tei index and 6-minute walking distance(6MWD)as well as pulmonary artery systolic pressure(PASP).Methods A total of 62 patients with COPD complicated by HP who were treated in our hospital from May 2017 to April 2019 were enrolled in the study,at the sme time,20 healthy subjects who underwent physical examination were enrolled as control group.According to the PASP value measured by ultrasound,the patients were divided into severe PH group,moderate PH group and mild PH group.The right ventricular Tei index,6MWD and red blood cell distribution width(RDW)were measured,and the correlation between Tei index and 6MWD as well as PASP was analyzed.Results The Tei index and RDW in case groups were significantly higher than those in control group(P<0.05).Tei index and RDW were increased with the increase of PASP,there were significant differences in Tei index and RDW among the three case groups(P<0.05).Moreover Tei index was negatively correlated with 6MWD(P<0.05),however,which was positively correlated with PASP(P<0.05).Conclusion Right ventricular Tei index can be used as a reference index for the early evaluation of right ventricular function in COPD patients with PH.