二维斑点追踪技术评价慢性阻塞性肺疾病患者右心室功能的研究

目的：利用二维斑点追踪技术（2D-STI）结合慢性阻塞性肺疾病评估测试（CAT）的分数探索慢性阻塞性肺疾病（COPD）患者右心室结构和功能的改变。方法：收集2020年9月至2021年12月在皖南医学院弋矶山医院门诊及住院的COPD患者和健康对照组,纳入67例COPD患者和30例健康志愿者,COPD患者依照CAT分数进行分组,1～20分为轻中度COPD组共33人、21～40为重度COPD组共34人,所有纳入对象均进行二维超声心动图和2D-STI获得右室游离壁纵向应变（RVFWLS）、室间隔应变（IVSLS）、右室整体纵向应变（RVGLS）,观察各组间是否存在统计学差异。进行CAT分数与心功能参数相关性分析以及不同超声医师利用2D-STI测量数据的一致性。结果：右心室基底段内径、心肌做功指数、右心室面积变化率的轻中度COPD组和重度COPD组与对照组有统计学差异（P<0.05）、轻中度COPD组与重度COPD组之间没有统计学差异（P>0.05）,IVSLS的重度COPD组与对照组有统计学差异（P<0.05）、轻中度COPD组和对照组之间没有统计学差异（P>0.05）。RVFWLS和RVGLS三组间均有统计学差异（P<0.05）。结论：COPD患者在未有明显临床症状时,右心室功能已发生损害,随着CAT分数的增加,损害更加严重,2D-STI可以早期的发现COPD患者右心室功能的改变,可作为评价右心室功能的一种新技术,利用CAT对患者临床症状进行评估更加贴近临床生活,可成为一种判断COPD患者右心室功能的简便方法。

Evaluation of right ventricular functionin patients with chronic obstructive pulmonary disease by two-dimensional speckle tracking imaging

Objective: The changes of right ventricle structure and function in patients with chronic obstructive pulmonary disease (COPD) were investigated by using 2D speckle tracking technique (2D-STI) combined with chronic obstructive pulmonary disease Assessment test (CAT) scores.Methods: COPD patients and healthy controls who were hospitalized and outpatients in Yijishan Hospital of Wannan Medical College from September 2020 to December 2021 were collected and Sixty-seven COPD patients and 30 healthy volunteers were included .COPD patients were grouped according to CAT score, 33 patients were divided into mild and moderate group from 1 to 20, and 34 patients were divided into recombinant group from 21 to 40. All included in the object of two-dimensional echocardiography and The longitudinal strain of the free wall of the right ventricle (RVFWLS), interventricular septum longitudinal strain(IVSLS) and right ventricular global longitudinal strain (RVGLS) were obtained by 2D-STI, and statistical differences were observed between groups. The correlation between CAT score and cardiac function parameters and the Consistency of measurement data by different sonographers using 2D-STI.Results: RVD1, FAC, Tei index of moderate and moderate group and recombinant group were statistically different from control group(P<0.05), and there was no significant difference between mild and moderate group and recombinant group (P>0.05), IVSLS recombination was statistically different from control group(P<0.05), there was no statistical difference between mild and moderate group and control group(P>0.05). There were statistically significant differences between RVFWLS and RVGLS groups (P<0.05).Conclusion: In patients with COPD is no obvious clinical symptoms, right ventricular function damage has occurred, with the increase of the CAT scores, damage is more serious, 2D-STIcan early find the change of right ventricular function in patients with COPD, can be used as evaluation of right ventricular function of a new technology, using the CAT to evaluate patients'' clinical symptoms is more close to the clinical life, It can be a simple method to judge right ventricular function in patients with COPD.