【摘要】 目的应用应变率成像技术检测慢性阻塞性肺病(COPD)患者右心室功能,探讨该技术评价COPD患者右心室功能的可行性。方法 COPD患者84例,对照组70例,心尖四腔观测量右室前壁舒张末期厚度(RVFT)、右房舒张末期内径(RAEDd)、右室舒张末期内径(RVEDd)、右室舒张末期面积(RVEDa)、右室收缩末期面积(RVESa)。结果根据肺动脉压将COPD患者分为无肺动脉高压组(NPAH)和肺动脉高压组(PAH);与对照组比较,PAH组RVFT显著增厚。RAEDd、RVEDd显著增大,RVFA及三尖瓣口E/A显著减小,NPAH组上述指标差异无统计学意义;与对照组比较,PAH组和NPAH组右室游离壁和室间隔SRs、SRe与SRe/SRa均显著降低,SRa无显著变化;与NPAH组比较,PAH组右室游离壁和室间隔SRs、SRe与SRe/SRa均显著降低,SRa无显著变化。COPD患者右室游离壁SRs与FEV1/FVC、DLco/VA呈显著正相关;而右室游离壁SRe、RVFA、三尖瓣口E/A与FEV1/FVC、DLco/VA无显著相关性。结论 COPD患者无论有无肺动脉压增高,其右室功能已经受损;应变率成像技术可便捷、无创检测COPD患者右室功能。更多还原

【Abstract】 OBJECTIVE To evaluate the right ventricular function in patients with chronic obstructive pulmonary disease(COPD)by strain rate imaging.METHODS Echocardiography was performed in 84 patients with COPD and 70 controls.Right ventricular frontal thickness(RVFT),right atrial end diastolic diameter(RAEDd),right ventricular end diastolic diameter(RVEDd),right ventricular end diastolic area(RVEDa),right ventricular end systolic area(RVESa),fraction of right ventricular area change(RVFA)and E/A of tricuspid valve flow were measured in 4-chamber apical view.Tissue velocity imaging(TVI)was accepted in apical four chamber apical views.The indies included peak systolic strain rate(SRs),peak early diastolic strain rate(SRe).peak late diastolic strain rate(SRa)and SRe/Sra.RESULTS According the pulmonary pressure,the patients with COPD were divided into 2 groups:group PAH(pulmonary artery hypertension)and group NPAH(non—pulmonary artery hypertension).Compared with controls,RVFT,RAEDd and RVEDd of group PAH increased significantly.RVFA and E/A decreased significantly,the upper indices of group NPAH had no significant difference;Compared with group NPAH,there was a significant positive correlation between FEV1/FVC and DLco/VA in patients with COPD;RVFT,RAEDd and RVEDd of group PAH increased significantly.RVFA and E/A decreased significantly,the upper indices of group NPAH had no significant difference,SRs,SRe and SRe/SRa of right ventricular free wall and interventricular septal in group PAH and group NPAH decreased significantly,but there was no significant difference of SRa.Compared with group NPAH,SRs,SRe and SRe/SRa of right ventricular free wall and interventricular septal in group PAH decreased significantly.but there was no significant difference of SRa;there was a significant positive correlation between SRs of right ventricular free wall and FEV1/FVC,DLco/VA in patients with COPD,but there was no significant correlation between SRe of right ventricular free wall and RVFA,E/A,FEV1/FVC and DLco/VA.CONCLUSION Function of right ventricle in patients with COPD can be damaged with or without pulmonary hypertension;SRI can detect right ventricular function in these patients easily and noninvasive.更多还原