组织多普勒Tei指数评价肺动脉高压患者右室功能的研究

摘要　目的　利用组织多普勒（TDI）频谱测算三尖瓣环局部心肌Tei指数及瓣环运动速度，探讨组织多普勒Tei指数评价肺动脉高压（PAH）患者右室功能的价值。方法　肺动脉高压患者63例,分为轻度、中度、重度3组，各21例，正常对照组21例, 超声心动图TDI技术分别于心尖四腔切面三尖瓣环室间隔(IVS)和右室游离壁(RVFW)2个位点测量等容舒张期、等容收缩期、射血期及右室Tei指数,并取其平均值Tei、IRT、ICT及ET。结果　(1) 4组间右室Tei指数比较差别均有统计学意义，在对照组、轻、中、重度组依次增高（p＜0.05或p＜0.01）。(2)3组PAH患者IRT与正常对照组比较均增大（p＜0.05）, 重度组IRT较轻度组增大，与中度组差异无统计学意义。重度PAH患者ICT与对照组及轻、中度PAH组比较明显增大（p＜0.05）。重度PAH组ET较对照组明显减小（p＜0.05），与轻、中度组比较差异无统计学意义。(3) 在三尖瓣环右室游离壁处测得的Tei指数于各组间均有差异（p＜0.05或p＜0.01），而在室间隔处测得的Tei数轻、中度组间差异无统计学意义（p＞0.05）结论　组织多普勒技术所测Tei指数可以较敏感、准确地定量反映肺动脉高压患者的右心室功能。

Usefulness of Tei Index Derived from Tissue Doppler Imaging for Assessment of Right Ventricular Function in Patients with Pulmonary Arterial Hypertension

Usefulness of Tei Index Derived from Tissue Doppler Imaging for Assessment of Right Ventricular Function in Patients with Pulmonary Arterial Hypertension Zhou Guiming, Zhao Lihui, Huang Canliang, Jia Lili, Chen Jingwan，Wanzheng Abstract Objective: To discuss the value of echocardiographic Tei index derived from Tissue Doppler Imaging(TDI) in evaluating right ventricular(RV) function in patients with pulmonary arterial hypertension(PAH).Methods: Sixty-three patients with pulmonary arterial hypertension were enrolled in this study. The patients were divided into three groups, mild group(PASP30～49 mmHg):included 21patients; moderate group(PASP50～69 mmHg): included 21 patients; severe group (PASP ≥70mmHg).Thirty-five normal individuals were enrolled as the control group.The Doppler sample volumes were placed at the interventricular septum(IVS) and RV free wall(RVFW) sites of tricuspid annular from the apical four-chamber view. RT,ICT,ET and RV Tei index were measured from IVS and RVFW by the TDI echocardiography. Results: (1) RV Tei index were of significant statistical difference among the four groups. (2) IRT were significantly higher in mild, moderate and severe groups compared with control group.And they were higher in severe group than in mild group, while there were no significant statistical difference between severe group and moderate group.ICT were significantly higher in severe group than in mild group, moderate group and control group.ET were significantly lower in severe group than control group，while there were no significant statistical difference between mild group, moderate group and severe g=-=++9roup . (3)RV Tei index derived from RVFW were of significant statistical fifference among the four groups,while there were no significant statistical difference between mild and moderate group when it mentioned to RV Tei derived from IVS.Conclusion:Tei index derived from TDI can reflect right ventricular function in patients with pulmonary arterial hypertension sensitively and exactly.