超声心动图检查对慢性肺源性心脏病患者右心功能的诊断价值

Diagnostic value of echocardiography in right heart function of patients with chronic pulmonary heart disease

目的 研究超声心动图检查对慢性肺源性心脏病患者右心功能的诊断价值。方法 选择90例确诊的慢性肺源性心脏病患者作为实验组,再根据疾病进展程度的不同分为A组(轻度)、B组(中度)、C组(重度),每组30例;另选取体检健康者90例作为对照组。所有研究对象均接受超声心动图检查。比较两组超声心动图指标[右房内径、右室内径、肺动脉内径、肺动脉平均压(MPAP)、肺动脉收缩压(PASP)],右心动图指标[射血分数(EF)、三尖瓣反流的最大速度(VTR)、舒张晚期A波峰值流速与舒张早期E波峰值流速比值(A/E)],分析超声心动图检查的诊断价值。结果 实验组的右房内径、右室内径、肺动脉内径、MPAP、PASP均大于对照组,差异具有统计学意义(P<0.05);实验组中A、B、C三组的右房内径、右室内径、肺动脉内径、MPAP、PASP均呈明显递增趋势(A组<B组<C组),组间两两比较,差异具有统计学意义(P<0.05)。实验组的VRT、A/E高于对照组, EF低于对照组,差异具有统计学意义(P<0.05);实验组中A、B、C三组的VRT、A/E均呈明显递增趋势(A组<B组<C组),EF呈明显递减趋势(A组>B组>C组),组间两两比较,差异具有统计学意义(P<0.05)。以病理诊断为金标准,超声心动图检查的漏诊率为2.22%(2/90)、准确率为97.78%(88/90);超声心动图检查检查的费用(43.24±10.56)元低于金标准的(103.54±20.78)元,出结果时间(5.23±1.05)h短于金标准的(5.60±1.01)h,差异具有统计学意义(P<0.05)。结论 运用超声心动图检查慢性肺源性心脏病患者右心功能的价值较高,可推广运用。

Objective To study the diagnostic value of echocardiography in right heart function of patients with chronic pulmonary heart disease. Methods 90 patients with confirmed chronic pulmonary heart disease were selected as the experimental group, and were divided into group A(mild), group B(moderate),and group C(severe) according to, with 30 cases in each group. Another 90 healthy subjects who underwent physical examination were selected as the control group. All study subjects underwent echocardiography. Both groups were compared in terms of echocardiographic indicators [right atrial diameter, right ventricular diameter,pulmonary artery diameter, mean pulmonary artery pressure(MPAP), pulmonary artery systolic pressure(PASP)], right cardiogram indicators [ejection fraction(EF), velocity of tricuspid regurgitation(VTR), ratio of peak A wave velocity in late diastole to peak E wave velocity in early diastole(A/E)], and the diagnostic value of echocardiography was analyzed. Results The right atrial diameter, right ventricular diameter, pulmonary artery diameter, MPAP, and PASP in the experimental group were greater than those in the control group, and the differences were allstatistically significant(P<0.05). In the experimental group, the right atrial diameter, right ventricular diameter, pulmonary artery diameter, MPAP, and PASP of groups A, B, and C all showed a significant increasing trend(group A < group B < group C), and the difference was statistically significant in pairwise comparison among the three groups(P<0.05). The VRT and A/E of the experimental group were higher than those of the control group, and the EF was lower than that of the control group, and the differences were statistically significant(P<0.05). In the experimental group, the VRT and A/E of groups A, B, and C all showed an obvious increasing trend(group A < group B < group C), and EF showed an obvious decreasing trend(group A > group B >group C), and the difference was statistically significant in pairwise comparison among the three groups(P<0.05).Taking pathological diagnosis as the gold standard, the missed diagnosis rate of echocardiography was 2.22%(2/90),and the accuracy rate was 97.78%(88/90). The cost of examination of echocardiography was(43.24±10.56) yuan,which was lower than(103.54±20.78) yuan of the gold standard;the time to result of echocardiography was(5.23±1.05) h, which was shorter than(5.60±1.01) h of the gold standard;the differences were all statistically significant(P<0.05). Conclusion The use of echocardiography to examine right heart function in patients with chronic pulmonary heart disease is of high value, and can be promoted.