| 摘要: |
| 目的：分析心脏超声和CT肺动脉成像(CTPA)在肺动脉高压(PH)右心功能及肺血管压力监测方面的应用价值。方法：纳入我院2017年6月~2019年12月收入的42例PH患者的数据资料予以统计和研究。42例患者在院期间均自愿行心脏超声和CTPA检查。对比两种检查方式在研究患者右心及肺血管结构中的测量值,分析其相关性；对比超声在不同程度PH患者右室射血分数(RVEF)、右室面积变化率(RVFAC)、三尖瓣环收缩期移位(TAPSE) 、右心室心肌功能Tei指数(RV Tei)等右心功能指标中的差异。结果：CTPA测出的患者右房横径和右房上下径的结果、患者右室基底段内径及右室前壁厚度的值、右室横径/心脏横径等各项指标均明显高于超声结果(P<0.05)；两种检查方法对患者右心结构各项测量结果均呈相关性,相关系数依次为0.381、0.434、0.416、0.546、0.486(均P<0.05)。CTPA测得的肺动脉主干内径(dPA)、主肺动脉直径/升主动脉直径(rPA)的结果均明显高于超声测量值(P<0.05)；两组检测结果系正相关,系数为0.453、0.422(均P<0.05)；且CTPA测得的rPA值与超声检测的肺动脉平均压是正相关(r=0.310,P<0.05)。超声测得不同病情程度患者的RVEF、RVFAC、RV Tei指数均有明显差异(P<0.05)。结论：心脏超声和CT肺动脉成像都是适用于肺动脉高压患者右心功能检查的方法,而心脏超声还能用于患者肺血管压力等动力学指标的直接监测,均值得临床推广。 |
| 关键词: 心脏超声 CT肺动脉成像 肺动脉高压 右心功能 肺血管压力 |
| DOI： |
| 投稿时间：2020-03-26修订日期：2020-04-22 |
| 基金项目: |
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| Application of cardiac ultrasound and CT pulmonary artery imaging in monitoring right heart function and pulmonary vascular pressure in patients with pulmonary hypertension |
| Huang Yong,Hu Qingmao,Huang Rui,Tang Lihan,Liu xingzhao |
| (Department of ultrasound,Jiangjin District Central Hospital,Chongqing,402260) |
| Abstract: |
| Objective: To analyze the value of cardiac ultrasound and CT pulmonary artery imaging (CTPA) in monitoring right cardiac function and pulmonary vascular pressure in pulmonary hypertension (PH). Methods: The data of 42 PH patients included in the income of our hospital in June 2017~ December 2019 were counted and studied. All 42 patients underwent voluntary cardiac ultrasound and CTPA examination during the hospital. The correlation was analyzed by comparing the measured values of the two methods in the study of right heart and lung vascular structure. Contrast ultrasound differences in right ventricular ejection fraction (RVEF), right ventricular area change rate (RVFAC), tricuspid annulus systolic displacement (TAPSE), right ventricular myocardial function Tei index (RV Tei) in patients with different degrees. Results: CTPA the results of right atrial transverse diameter and right atrial upper and lower diameter, the values of right ventricular basal segment inner diameter and right ventricular anterior wall thickness, right ventricular transverse diameter/heart transverse diameter were significantly higher than those of ultrasound(P<0.05). The correlation between the two methods was 0.381,0.434, 0.416,0.546,0.486(all P<0.05). CTPA measured pulmonary artery trunk diameter (dPA), aortic diameter/liter aortic diameter (rPA) were significantly higher than those measured by ultrasound(P<0.05). The results were positively correlated and the coefficients were 0.453,0.422(all P<0.05). And CTPA rPA values were positively correlated with the mean pulmonary artery pressure measured by ultrasound(r=0.310, P<0.05). The RVEF、RVFAC、RV Tei index of patients with different degree of disease was significantly different by ultrasound (P<0.05). Conclusion: Both cardiac ultrasound and CT pulmonary artery imaging are suitable for right cardiac function examination in patients with pulmonary hypertension, and cardiac ultrasound can also be used for direct monitoring of patients with pulmonary vascular pressure and other kinetic indicators, which are worthy of clinical promotion. |
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