心肌工作指数评价肺源性心脏病患者右心功能的临床研究

目的:探讨运用组织多普勒成像技术(tissue Doppler imaging,TDI)测量右室心肌工作指数(Myocar-dial performance index,MPI)对肺源性心脏病患者右心整体功能评定的临床价值。方法:研究对象共92例,其中正常对照组40例,肺源性心脏病患者52例。依据多普勒超声测定肺动脉收缩压(pulmonary systolic pressure,PASP)值将肺源性心脏病患者分为三组:轻度肺动脉高压组(PSAP30～50mmHg)25例,中度肺动脉高压组(PSAP51～70mmHg)17例;重度肺动脉高压(PSAP>70mmHg)10例。所有研究对象均进行常规超声指标测量,并运用TDI技术获取右房室瓣各瓣环处的组织多普勒运动频谱图,测量相关时间间期,应用公式MPI=(IRT+ICT)/ET计算出MPI值,观察肺动脉收缩压与MPI之间的相关性。结果:重度及中度肺动脉高压组MPI较轻度肺动脉高压组、对照组高,重度肺动脉高压组高于其他各组,肺动脉收缩压与MPI存在正相关关系(r=0.66,P<0.01)。结论:MPI与肺动脉收缩压升高程度有关,肺动脉收缩压越高,MPI升高越明显,提示肺心病患者随着肺动脉压的增高,右心室整体功能下降。

Evaluating the right ventricular function of patients with pulmonary heart disease by myocardial performance index

Objective:To investigate the value of MPI measured by tissue Doppler imaging (TDI) in evaluating the right ventricular function of patients with pulmonary heart disease. Methods:92 subjects were selected in this study. There were 40 healthy volunteers in this study (the normal control group,n=40); 52 patients with pulmonary heart disease were divided into 3 groups: the mild group (PSAP 30～50mmHg,n=25), the moderate group (PSAP 51～70mmHg,n=17) and the severe group (PSAP>70mmHg,n=10) according to pulmonary artery systolic blood pressure. All the people received echocardiography studies and MPI measured by TDI. The correlation between MPI and PSAP with different grades was evaluated and compared. Results:The values of MPI were significanly higher in the moderate PAH group and the severe PAH group than the mild PAH group and the normal control group; There were significant correlations between MPI and PSAP score in 4 diferent sample locations (r=0.66, P<0.01). Conclusion:MPI index measured by TDI is a sensitive indicator for the right ventricular global function.