组织多普勒评价慢阻肺患者右心功能的价值研究

Evaluation of right ventricular function in patients with chronic obstructive pulmonary disease by tissue Doppler imaging

目的 :探讨超声组织多普勒成像评价慢性阻塞性肺疾病患者右心功能的价值。方法 :选取2014年6月～2017年7月我院呼吸科收治的慢性阻塞性肺疾病患者102例(根据肺动脉高压分为轻度、中度、重度三组),选择同期体检健康人群84例(对照组)行组织多普勒检查、常规心动图检查及肺功能测评,计算右心室Tei指数。结果 :COPD患者各组RVWT、MPA、RVD、RAD水平均明显高与对照组,差异显著,COPD患者组三组间上述指标由高到低依次为:重度>中度>轻度,三组间两两比较差异显著;COPD患者各组Sm、Em、Am、FEV1/FVC、Em/Am均明显低于对照组,COPD患者各组Tei指数较对照组升高,差异显著;COPD患者Sm、Em、Am、FEV1/FVC、Em/Am指标水平由高到低依次为:轻度>中度>重度,Tei指数由高到低依次为:重度>中度>轻度;对Tei指数与FEV1/FVC进行相关性分析,两者呈负相关。结论 :组织多普勒Tei指数可无创定量的评价COPD患者的右心功能,并可以为COPD患者的治疗及预后提供参考。

Objective To evaluate the value of ultrasound tissue Doppler imaging in evaluating right ventricular function in patients with chronic obstructive pulmonary disease. Methods 102 patients with chronic obstructive pulmonary disease from June 2014 to July 2017 in the Department of respiration in our hospital(according to the cases of pulmonary hypertension and divided into mild, moderate and severe group three), 84 cases of healthy check-up group(control group) underwent Doppler tissue imaging, conventional echocardiography and pulmonary function evaluation, calculation of right ventricular Tei index. Results COPD, MPA, RVD in patients with RVWT and RAD levels were significantly higher than those in control group, the difference was significant, COPD patients between the three groups of the index from high to low: mild moderate severe > > three, and there was significant difference between the 22 groups; group Sm, Em in patients with COPD Am, FEV1/FVC and Em/Am were significantly lower than the control group, COPD in patients with Tei index was higher than the control group, significant difference; COPD, Em, Am, Sm in patients with FEV1/FVC, Em/Am index level from high to low: mild moderate severe Tei > >, the index is in the following order low: > > mild moderate and severe; analyze the correlation between the Tei index and FEV1/FVC, there is a negative correlation between them. Conclusion Tissue Doppler Tei index can noninvasively evaluate the right ventricular function in patients with COPD, and can provide a reference for the treatment and prognosis of COPD patients.