| 摘要: |
| 目的：探讨连续多普勒超声对特发性肺动脉高压 (IPAH) 患者不同时相肺动脉压与心导管检测肺动脉压之间的关联。方法：选取2013年6月~2016年3月期间在我院因胸闷、气促等临床可疑IPAH患者113例作为研究对象，利用连续多普勒超声心动图对经心导管确诊的78例IPAH患者主肺动脉内径 (MPA) 、右心房左右径 (RAT) 、左、右心室舒张末期左右径 (LVT 、RVT) 及前后径 (LVD 、RVD) ，计算其右心室与左心室左右径的比值 (RVT/ LVT) 、前后径的比值 (RVD/LVD) ；记录三尖瓣反流最大压差 (收缩压) 、肺动脉瓣舒张早期及末期反流压差 (舒张压) 并计算平均压，将多普勒超声心动图的相关检测指标与心导管测量不同时相肺动脉压力值进行比较。结果：1.超声估测肺动脉高压的灵敏度、特异度、阳性预测值、阴性预测值及准确度分别为87.2%,74.3%,88.3%,72.2%,83.2%.2.本研究中经心导管确诊的78例患者均存在不同程度的三尖瓣反流或肺动脉瓣反流，其中三尖瓣反74例，肺动脉瓣反流62例，两种情况同时存在58例；经多普勒超声心动图检测的IPAH患者的肺动脉收缩压 (PASPe) 、舒张压 (PADPe) 及平均压 (PAMPe) 与右心导管检测的收缩压 (PASPc) 、舒张压(PADPc) 及平均压 (PAMPc) 之间均存在显著相关性 (r=0.667；0.639；0.636，P均<0.05) ；同时，MPA、RAT、RVT/LVT以及RVD/LVD与PASPc之间均存在相关性 (P<0.05) ，RAT、RVT/LVT以及RVD/LVD与PASPc之间相关性最为明显 (P<0.001) 。结论：多普勒超声对IPAH患者不同时相肺动脉压的评估与右心导管测量肺动脉压之间存在显著相关性，利用多普勒超声测量三尖瓣及肺动脉瓣反流对IPAH患者肺动脉压的评估具有较高的准确性，是无创评估肺动脉高压的首选方法。 |
| 关键词: 彩色多普勒超声 心导管 肺动脉压 |
| DOI： |
| 投稿时间：2017-05-10修订日期：2017-06-09 |
| 基金项目: |
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| Correlation investigation of pulmonary artery pressure at different phases assessed by CW Doppler Echocardiography and cardiac catheterization in patients with Idiopathic Pulmonary Arterial Hypertension |
| caiyanjuan,luoxiaoyong |
| () |
| Abstract: |
| objective: to investigate the correlation of pulmonary artery pressure assessment at different phases by CW Doppler Echocardiography and cardiac catheterization in patients with Idiopathic Pulmonary Arterial Hypertension (IPAH) . Methods: 113 cases of patients with symptoms of chest stuffy and pneumatic, etc. are suspicious of IPAH in our hospital from June 2013 to March 2016 were enrolled in the study, in the 78 patients diagnosed with cardiac catheterization, Main pulmonary artery diameter (MPA), right atrium transverse diameter (RAT), end-diastolic transverse diameter ( LVT) and axial diameter of both right and left ventricle (RVD, LVD) were measured by echocardiogram, the ratio of transverse diameter between right ventricle and left ventricle (RVT/LVT), the ratio of axial diameter (RVD/LVD). Peak systolic pressure of pulmonary artery was evaluated by pressure gradient of tricuspid regurgitation with Doppler echocardiogram。The peak diastolic pressure and average pressure of pulmonary artery was assessed with the earlier and late pressure gradient via pulmonary regurgitation. These pressure measurements at different phases with both the Doppler assessment via tricuspid and pulmonary valve regurgitation and cardiac catheterization were compared, and the correlation was analyzed as well. Results:1.Sensitivity,specificity,positive predictive value，negative predictive values and accuracy of CW Doppler Echocardiography Was 87.2%,74.3%,88.3%,72.2%，83.2%. 2.There were 74 cases with tricuspid regurgitation, 62 cases with pulmonary valve regurgitation and 58 cases with both situations in all the 78 patients. There were good correlation on PASPe, PADPe and PAMPe between the values with Doppler echocardiogram and cardiac catheterization method (r=0.667,0.639,0.636，all P<0.05). There were good correlation between the echocardiographic parameters of MPA, RAT, RVT/LVT, RVD/LVD and PASPc (P<0.05), significant correlation was noted between RAT、RVT/LVT,RVD/LVD and PASPc(P<0.001). Conclusion: There were significant correlations on the pulmonary artery pressure at different phases measured by tricuspid regurgitation and pulmonary valve regurgitation between Doppler echocardiography and cardiac catheterization in patients with IPAH. It is the first method on the noninvasive assessment of pulmonary hypertension in patients with IPAH. |
| Key words: : Color doppler flow imaging (CDFI) Cardiac catheterization. Pulmonary artery pressure |
