多普勒超声心动图在诊断原发性肺动脉高压的应用

Diagnosing primary pulmonary hypertension with Doppler echocardiography

目的 探讨多普勒超声心动图对原发性肺动脉高压 (PPH)诊断和鉴别诊断的价值。方法 回顾性分析 75例PPH患者的超声诊断 ,部分与心导管结果对照。结果 75例PPH患者中 ,超声诊断 67例 ,诊断符合率达 89.3 %;其中有18例与心导管检查对比 ,两者对肺动脉压力的测定结果无明显差异 (89.3± 2 3 .2 )mmHgvs (80 .8± 2 5 .6)mmHg ,P >0 .0 5 ,两种方法相关性好 (r =0 .82 ,P <0 .0 0 1) ;早期PPH患者左心收缩功能可正常 ,晚期严重PPH患者则降低。结论 超声心动图可无创、准确测定PPH患者肺动脉压力 ,重复性好 ;超声心动图在PPH诊断与鉴别诊断方面有一定的价值 ;超声心动图检测PPH患者左室收缩功能 ,可了解病情进展和评估疗效。

Objective To evaluate the reliability of Doppler echocardiography in the diagnosis and differential diagnosis of primary pulmonary hypertension (PPH). Methods The clinical materials and laboratory results of 75 patients with PPH were retrospectively analyzed. The pulmonary systolic pressure was measured with continue wave (CW) Doppler through the tricuspid valve regurgitation. Left ventricular systolic function was given by M-mode echocardiography. Results Sixty-seven in 75 patients with PPH were initially diagnosed by echocardiography with accuracy of 89.3%. Compared with the right heart catheterization performed in eighteen patients,the pulmonary arterial pressure determined by echocardiography was comparable to (89.3±23.2) mmHg vs (80.8±25.6) mmHg ( P >0.05),and correlated with that measured by right heart catheterization ( r =0.82,P <0.001). Left ventricular systolic function could be normal at the early stage and becomes deteriorated getting to the advanced stage of PPH. Conclusion As a non-invasive,duplicative diagnostic tool,echocardiography is able to provide veracious and important information for the diagnosis and differential diagnosis of PPH.