脉冲多普勒Tei指数评价原位肝移植术前肝硬化患者心功能的价值

Cardiac function assessed by pulsed wave doppler imaging with Tei index in patients with liver cirrhosis before orthotopic liver transplantation

目的探讨脉冲多普勒Tei指数评价原位肝移植(OLT)术前肝硬化患者的左心及右心功能的价值。方法选择2014年5月至9月天津市第一中心医院收治的38例OLT术前肝硬化患者作为肝硬化组,27例年龄相匹配的正常人作为正常对照组,两组均行彩色多普勒超声心动图检查,测量左心室射血分数(LVEF)、右心室射血分数(RVEF)、二尖瓣及三尖瓣舒张早期血流峰值(E峰)、舒张晚期血流峰值(A峰),计算并比较E/A比值及Tei指数。结果 OLT术前的肝硬化患者左心室舒张末期内径(LVDd)、左心房收缩末期内径(LADs)、右心室舒张末期内径(RADs)、右心房收缩末期内径(RADd)、LVEF、RVEF、E/A比值与正常对照组比较差异均无统计学意义(均P>0.05);而肝硬化患者左心室Tei指数(0.56±0.12)、右心室的Tei指数(0.46±0.10)均高于正常对照组(分别为0.41±0.07、0.37±0.06),两组比较差异均有统计学意义(均P<0.05)。结论脉冲多普勒Tei指数是评估心功能的一种简便易行的可靠方法,可用于评价OLT术前肝硬化患者的心脏整体收缩和舒张功能,为临床治疗提供指导。

ObjectiveTo evaluate the left and right ventricular function by Tei index assessed by pulsed wave doppler imaging in patients with liver cirrhosis before orthotopic liver transplantation(OLT).Methods In Tianjin First Center Hospital,between May2014 and September2014,we choose38 patients with liver cirrhosis before OLT as cirrhosis group,27 healthy controls as control group and let them underwent color doppler echocardiography. The peak filling velocity of E wave and A wave, ejection fraction(EF)of left and right ventricular were measured, E/A and Tei index were calculated and compared.Results There was no significant difference in left ventricular end diastolic diameter(LVDd)、left atrial end systolic diameter(LADs)、right ventricular end diastolic diameter(RVDd)、right atrial end systolic diameter(RADs)、EF of left and right ventricular and E/A(allP>0.05)between cirrhosis group and control group. Tei indices of left and right ventricle in cirrhosis group(0.56±0.12,0.46±0.10) were higher than those of normal control group(0.41±0.07,0.37±0.06) (bothP<0.05).Conclusion Tei index assessed by pulsed wave Doppler imaging is a good way to evaluate the global heart function. It can be used to evaluate the patients with liver cirrhosis before OLT and provide guidance for clinical treatment.