解剖M型超声心动图测量肺动脉主干运动曲线及其影响因素分析

目的 应用解剖M型超声心动图观察肺动脉主干运动曲线的特点,并探讨其影响因素.方法 收集肺动脉压正常的160例患者,应用解剖M型超声心动图观察肺动脉主干运动曲线,测定肺动脉干前侧壁搏动幅度(PAWPA),并随机抽取20例采用组内相关系数检验对PAWPA测量值进行两位观察者间盲法一致性分析以及同一观察者不同时间的一致性分析.采用多元逐步回归模型,分析年龄、性别、心率、血压、动脉粥样硬化、右心房内径、肺动脉瓣关闭不全等因素对PAWPA的影响. 结果 PAWPA测定值在观察者间与观察者内一致性均好,组内相关系数值分别为0.91(95%CI:0.37～0.99)与0.95(95%CI:0.60～0.99).PAWPA与年龄(β=-0.47,P<0.001)、心率(β=-0.29,P<0.005)呈负相关, 与性别、血压、动脉粥样硬化、右心房内径、肺动脉瓣关闭不全等因素无显著相关. 结论 解剖M型超声心动图可用于观测PAWPA,该指标一致性好、重复性高.在肺动脉压正常的情况下,年龄与心率是其重要影响因素.

Observation of pulmonary artery motion curve with anatomical M-mode echocardiography and analysis of influential factors

Objective To observe the pulmonary artery motion curve with anatomical M-mode echocardiography, and to investigate its influential factors. Methods The pulmonary artery motion curve was detected and pulsating amplitude of pulmonary artery wall (PAWPA) was measured with anatomical M-mode echocardiography in 160 patients with normal pulmonary artery pressure. Intraclass correlation coefficient (ICC) was used to assess inter-observer conisitency of PAWPA measurements between two investigators who were blinded to each other's findings, and intra-observer consistency of PAWPA with repeating the measurements on two occasions by the same investigator in 20 randomly selected cases. Stepwise multiple regression was used to analyze the following potential influential factors of PAWPA: age, gender, heart rate, blood pressure, atherosclerosis, right atrial diameter, and pulmonary insufficiency. Results There was good consistency between two independent observers' measurements and between two occasions in the same observer's measurements for PAWPA with ICC values of 0.91 (95% CI, 0.37-0.99) and 0.95 (95% CI, 0.60-0.99), respectively. PAWPA was negatively correlated with age (β=-0.47, P<0.001) and heart rate (β=-0.29, P<0.005). There was no correlation of PAWPA with gender, blood pressure, atherosclerosis, right atrial diameter, and pulmonary insufficiency. Conclusion Anatomical M-mode echocardiography can be used for measuring PAWPA with good consistency and reproducibility. In normal pulmonary artery pressure cases, PAWPA is affected by age and heart rate.