超声心动图在急进高原人员心室功能评价中的应用

目的 应用超声心动图定量评价急进高原人员的心室功能.方法 对44例急进高原（玉树,平均海拔4200米以上）人员和24名年龄、性别匹配的平原对照人群进行常规超声心动图检查,同时采用组织多普勒（tissue doppler imaging,TDI）测量左、右心室心肌的心肌做功指数（Tei指数）进行统计分析.结果 急进高原人员和平原对照组相比,肺动脉收缩压增加（P〈0.01）,而左、右心房室内径、左心室射血分数（left ventricular ejection fraction,LVEF）、右心室面积改变分数（fractional area change,FAC）差异无统计学意义.TDI分析显示与平原组相比,急进高原人员左心室心肌收缩及整体功能均有减低,即二尖瓣环舒张早期峰值速度（annular velocity,Em）有明显减低,左心室Tei指数明显增高（P〈0.01）.2组之间三尖瓣峰值速度（annular velocity,Em）和右心室Tei指比较,数差异无统计学意义.结论在急进高原人员中,TDI测定的Tei指数可以早期显示心室整体功能的异常.

Application of echocardiography in the cardiac function assessments of people rapidly traveling to highlands

Objective To evaluate ventficular function of the travelers who rushed into high lands with echocardiography quantitatively. Methods Routine echocardiography was performed in the 44 cases of people who rushed into high land （ Yushu, with an average altitude more than 4200 meters ） and 24 cases of control subjects in plain who are age-and sex-matched, while myocardial performance index（ Tei index） of left and right ventricular myocardium were measured using tissue doppler（TD1）. Student T test was used for statistical analysis. Results Compared with the plain control group, systolic pulmonary artery pressure increased（ P〈0.01 ） in high land group, while the differences in the atrial and ventricular diameters of left and fight heart, left ventricular ejection fraction（ LYEF）, fractional area change （FAC） of right ventricular were not statistically significant. TD1 analysis showed that compared with the plain control group, left ventricular myocardial contractility and overall function were reduced in high land group, namely peak early diastolic mitral annular velocity（Era） significantly reduced, and left ventricular Tei index significantly increased（ P〈0.01 ）. There were no significant difference in tricuspid peak velocity （Em） and right ventricular Tel index between these 2 groups. Conclusion Left ventricular dysfunction of high land people be detected early, safely, and noninvasively with eehocardiography.