实时三维超声心动图对急性肺栓塞患者右心功能的评估(1)
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[摘要] 目的：探讨实时三维超声心动图(RT-3DE)评价急性肺栓塞(APE)患者右心功能的价值。方法：使用RT-3DE采集30例APE患者和30例健康志愿者心脏全容积图像导入TomTec工作站，应用4D RV-Function软件分析，生成右室容积-时间变化曲线(RV-VTC)。比较两组对象RT-3DE参数右室舒张末期容积(EDV)、收缩末期容积(ESV)，射血分数(EF)，峰值排空率(PER)和峰值充盈率(PFR)之间的差异。结果：与对照组相比，APE患者右室整体EDV、 ESV增大，EF、PER、PFR减小，差异均有统计学意义(t=2.490、2.172、2.897、2.894及3.042，均P<0.05)。结论：APE患者的右室整体收缩及舒张功能减低，RT-3DE可以准确评价APE患者右心功能改变。
[关键词] 三维超声心动图；实时显像；肺栓塞
[中图分类号] R542.2 [文献标识码] B [文章编号] 1673-7210(2011)11(c)-105-02
Evaluation of global right ventricular function in patients with acute pulmonary embolism using Real-time Three-dimensional echocardiography
LIU Huan, CAO Yunxiang, QIAN Dajun
Department of Cardiac Function, the Affiliated Wuxi People′s Hospital of Nanjing Medical University, Jiangsu Province, Wuxi 214023, China
[Abstract] Objective: To explore the value of the right ventricular (RV) global function in patients with acute pulmonary embolism (APE) by using real-time Three-dimensional echocardiography (RT-3DE). Methods: 30 normal controls and 30 patients with APE were studied. And all the three-dimensional echocardiographic datasets were acquired. Then series of RV parameters, namely end diastolic volume (EDV), end systolic volume (ESV), RV ejection fraction (EF) were offline measured by TomTec 4D RV-Analysis software which can also provide the right ventricular volume-time curves (RV-VTC). EDV, ESV, EF, RV peak filling rate (PFR) and RV peak ejection rate (PER) from RT-3DE were investigated in the two groups. Results: Compared with control group, the value of EDV and ESV were larger; EF, PER, PFR were reduced, there were significant differences in the two groups (t=2.490, 2.172, 2.897, 2.894 and 3.042, respectively, all P<0.05). Conclusion: The RV function in patients with APE is decreased and RT-3DE can evaluate RV volume and global function accurately.
[Key words] Three-dimensional echocardiography; Real-time imaging; Pulmonary embolism
急性肺栓塞(APE)是一种威胁患者生命的常见心血管疾病，其肺动脉高压引起右心室(RV)压力负荷急剧增大，导致右心功能损伤，进一步发展为右心衰竭和全心衰竭[1-2]。研究显示合并右心功能不全的病例90 d死亡率明显提高，多元回归分析提示右室功能不全是APE远期预后的一项独立危险因素和不良预后的早期预警[3] ......
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