| 摘要: |
| 目的: 探讨二维斑点追踪技术在评价不同程度三尖瓣反流患者右心室功能中的价值。方法: 选取2021年3月-2021年12月在弋矶山医院超声科确诊为TR的患者78例及健康志愿者39例，共117例，将患者分为非显著TR组39例和显著TR组39例。经胸超声心动图获取常规超声数据，即Tei指数、TAPSE、RVFAC、IVA、S’、右心室基底段内径、右心室中间段内径、右心室长轴内径、三尖瓣环舒张末期直径、TAC及右房面积，其次应用2D-STI获取RVGLS，比较上述各组参数的差异。结果: 三组RVGLS值相比，显著TR组最大，非显著TR组其次，正常对照组最小，差异有统计学意义（P＜0.05）；三组Tei指数、TAPSE、RVFAC，显著TR组与非显著TR组及正常对照组相比，差异有统计学意义（P＜0.05）；三组右心室基底段、中间段、长轴内径及三尖瓣环舒张末期直径相比，显著TR组较非显著TR组及正常对照组降低，差异有统计学意义（P＜0.05）；三组TAC相比，显著TR组最小，非显著TR组其次，正常对照组最大，差异有统计学意义（P＜0.05）；RVGLS与反流颈及反流面积呈正相关（r分别为0.643、0.723），RVGLS与TAC呈负相关（r为-0.573），差异均具有统计学意义（P＜0.05）。利用ROC曲线确定RVGLS＞-20%的临界值为反流面积≥6.365cm2、反流颈宽度≥3.15mm，敏感度分别为94.3%、91.4%，特异度为86%、 86%。结论：非显著TR患者右心室功能已经受损，显著TR患者右心室功能受损进一步加重，2D-STI作为一项新技术可以早期发现右心室功能的变化，且反流面积及缩流颈宽度与RVGLS显著相关，期待成为临床早期诊疗的参考指标。 |
| 关键词: 三尖瓣反流 斑点 斑点追踪成像 右心 右心室功能 |
| DOI： |
| 投稿时间：2022-05-26修订日期：2022-07-18 |
| 基金项目:芜湖市科技计划项目（2020ms3-5）。安徽省2017年公益性技术应用研究联动计划项目（1704f0804048） |
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| A preliminary study of two-dimensional spot tracking techniques to assess right ventricular function in patients with tricuspid regurgitation |
| ZHAO Tian-ying,ZHANG-xia,ZHAO-yazi,SHI zixuan |
| (Department of Ultrasound,Yijishan Hospital,The First Affiliated Hospital of Wannan Medical University) |
| Abstract: |
| Objective：To explore the value of Two-dimensional speckle-tracking in evaluating right ventricular function in patients with varying degrees of tricuspid regurgitation. Methods: From March 2021 to December 2021, 78 patients and 39 healthy volunteers were diagnosed with TR in the Ultrasound Department of Yijishan Hospital, a total of 117 patients, and the patients were divided into 39 cases in the non-significant TR group and 39 cases in the significant TR group. Common echocardiographic parameters were measured by transthoracic echocardiography，For example：Tei index, TAPSE, RVFAC, IVA, S', right ventricular basal base segment inner diameter, right ventricular middle segment inner diameter, right ventricular long axis inner diameter, tricuspid valve ring end-diastolic diameter, TAC，and the RVGLS was obtain by 2D-STI , comparing the differences in the above sets of parameters.Results: Compared with the RVGLS values in the three groups, the significant TR group was the largest, the non-significant TR group was the second, and the normal control group was the smallest, and the difference was statistically significant (P<0.05); the difference between the Tei index, TAPSE, RVFAC and the significant TR group was statistically significant compared with the non-significant TR group and the normal control group (P<0.05), and the diameter of the right ventricular basal segment, the middle segment and the terminal diastolic diameter of the tricuspid valve ring were reduced compared with the non-significant TR group and the normal control group. The difference was statistically significant (P<0.05); compared with the three groups of TAC, the significant TR group was the smallest, the non-significant TR group was the largest, and the difference was statistically significant (P<0.05); RVGLS was positively correlated with the reflux neck and reflux area (r=0.643, 0.723), and RVGLS was negatively correlated with TAC (r = -0.573), and the differences were statistically significant (P<0.05). The critical value of RVGLS >-20% was determined by ROC curve as the reflux area ≥ 6.365cm2, the vena contracta width ≥ 3.15mm, the sensitivity was 94.3%, 91.4%, and the specificity was 86%、 86%, respectively.Conclusion: The right ventricular function in the non-significant TR group has been impaired, and the right ventricular function impairment in the significant TR group has been further aggravated. As a new technology, 2D-STI can detect changes in right ventricular function early, and RVGLS is significantly related to the degree of reflux, which expect become a reference index for early clinical diagnosis and treatment. |
| Key words: Tricuspid regurgitation Spots Speckle tracking imaging Right heart Right ventricular function |
