实时三维超声心动图评价肺动脉高压患者右心室收缩功能

目的 运用实时三维超声心动图(RT-3DE)评价肺动脉高压患者右心室收缩功能.资料与方法 97例肺动脉高压患者按照肺动脉收缩压分为3组:轻度组30例,中度组35例,重度组32例；选取31名正常成人作为对照.采用RT-3DE检测受试者右心室整体及三节段的舒张末期容积、收缩末期容积、搏出量和射血分数.结果 中、重度组右心室整体收缩末期容积明显大于正常组及轻度组(P＜ 0.05或P＜0.01),右心室射血分数明显低于正常组及轻度组(P＜0.01).三节段研究显示:重度组右心室流入道的收缩末期容积明显大于正常组(P＜0.05)及轻度组(P＜0.01),中度组收缩末期容积大于轻度组(P＜0.05)；中、重度组的右心室射血分数均明显低于正常组及轻度组(P＜0.01)；小梁部舒张末期容积以中度组增大最为明显(P＜0.05),中、重度组收缩末期容积明显增大(P＜0.05),搏出量和射血分数各组间均无统计学意义(P＞0.05).右心室流出道的右心室收缩功能参数各组间均无统计学意义(P＞0.05).结论 中度以上的肺动脉高压患者存在右心室整体及流入道收缩功能损害.

Evaluation of Right Ventricular Systolic Function in Patients with Pulmonary Hypertension Using Real-time Three-dimensional Echocardiography

Purpose To evaluate the right ventricular systolic function in patients with pulmonary hypertension (PH) using real-time three-dimensional echocardiography (RT-3DE). Materials and Methods 97 patients with PH were divided into three groups according to pulmonary arterial pressure (PASP) level: mild group consisted of 30 cases, moderate group consisted of 35 cases, severe group consisted of 32 cases. 31 healthy cases were included as controls. The end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and right ventricle ejection fraction (RVEF) of global right ventricle and inflow tract, trabeculae, outflow tract of all subjects were detected by using RT-3DE. Results Global RV ESV increased in moderate and severe groups (P<0.05 or P<0.01), but RVEF decreased (P < 0.01). The rESV of RV inflow tract in the severe group was higher than that of normal and mild groups; the rESV of RV inflow tract of moderate group was higher than that of mild group (P<0.05), but rRVEF of the two groups were decreased (P<0.01). Mild group had increased RV trabeculae regional rEDV (P<0.05); moderate and severe groups had increased RV trabeculae regional rESV, but rSV and rRVEF were not statistically different in all groups (P> 0.05). Regional volume and ejection fraction of RV outflow tract were not statistically different in all groups (P>0.05). Conclusion Global RVEF and rRVEF of RV inflow tract are decreased in moderate and severe PH patients.