中日欧健康成人多普勒超声心动图参数测值的对比研究

Comparative study of Doppler echocardiographic reference values in healthy adults of Chinese,Japanese and Europeans

目的探讨中国(EMINCA研究)与日本(JAMP研究)、欧洲(NORRE研究)健康成人超声心动图正常值研究中多普勒参数测值的异同。方法根据文献中JAMP研究和NORRE研究中的多普勒参数, 从中国EMINCA研究原始数据库中选取对应的参数, 并进行对应的性别和年龄段分组。采用独立样本t检验、摘要独立样本t检验、单因素方差分析(ANOVA)比较组间差异, Pearson相关分析比较多普勒参数与年龄间的相关性。结果①获得12个共同参数:二尖瓣舒张早期(E峰)与舒张晚期(A峰)血流速度峰值及两参数比值(E/A), E峰减速时间(DT), 舒张早期二尖瓣环间隔处(septal-e′)与侧壁处(lateral-e′)峰值速度及两参数均值(average-e′), 舒张晚期二尖瓣环间隔处(septal-a′)与侧壁处(lateral-a′)峰值速度, E峰与septal-e′、lateral-e′比值(septal-E/e′、lateral-E/e′), septal-E/e′与lateral-E/e′均值(average-E/e′)。②性别间差异:EMINCA研究5/10、JAMP研究8/10、NORRE研究3/12个参数差异有统计学意义(均P<0.05)。③按性别、年龄段分组:除EMINCA研究中男性DT外, 其余参数在三项研究中不论男女性, 年龄段间差异均有统计学意义(P<0.05)。④EMINCA与JAMP研究比较:男性8/10、女性9/10个参数差异有统计学意义(均P<0.05)。⑤EMINCA与NORRE研究比较:男女性各有7/12个参数差异有统计学意义(均P<0.05)。⑥三项研究中, 不论男女性, 6/10个参数与年龄呈正相关(r=0.12~0.66, 均P<0.001), 4/10个参数与年龄呈负相关(r=-0.27~-0.72, 均P<0.001)。结论健康成人多普勒超声心动图参数测量值在不同性别间、年龄段间以及种族或国家间存在显著性差异, 建议采用性别、年龄段和种族或国家特异的多普勒超声心动图参数参考值范围。

Objective To investigate the similarities and differences of Doppler echocardiographic parameters in healthy adults among Chinese(EMINCA study),Japanese(JAMP study)and Europeans(NORRE study).Methods Based on the published Doppler echocardiographic data of JAMP and NORRE studies,the corresponding Doppler parameters were selected from the original database of EMINCA study and stratified by sex and age groups accordingly.Independent-samples t-test,summary t-test,and one-way analysis of variance(ANOVA)were used to test the differences between groups.Results①Common Doppler parameters in three studies included:peak velocities of early diastolic(E)and late diastolic waves(A)of mitral valve inflow,E/A ratio,deceleration time(DT)of E wave,tissue velocities of early diastole(e′)and late diastole(a′)at both septal and lateral sites of the mitral annulus and the average value of e′at both sites(average-e′),ratios of E to septal e′(septal-E/e′),E to lateral e′(lateral-E/e′),and E to average e′(average-E/e′).②Differences between genders:There existed significant gender differences for 5/10 of parameters in EMINCA study,8/10 in JAMP study and 3/12 in NORRE study(all P<0.05).③Stratification by sex and age groups:Except for DT for men in EMINCA study,significant differences were found in all 12 Doppler parameters both for men and women in all three studies(all P<0.05).④Comparison between EMINCA and JAMP studies:There were statistically significant differences in 8/10 and 9/10 of parameters for men and women,respectively(all P<0.05).⑤Comparison between EMINCA and NORRE studies:7/12 of parameters both in men and women were significantly different between the two studies(all P<0.05).⑥For the three studies,6/10 of parameters both in men and women correlated positively with age(r=0.12-0.66,all P<0.001),while 4/10 correlated negatively with age(r=-0.27--0.72,all P<0.001).Conclusions Doppler echocardiographic measurements in healthy adults are significantly different with genders,ages and races/nationalities.Therefore,gender,age and race/nationality-specific reference values of Doppler echocardiography parameters should be encouraged in clinical practice.