【摘要】 目的 探讨经胸超声心动图(TTE)和右心导管检查(RHC)评估肺动脉高压(PAH)患者血流动力学参数的价值。方法 选取2017年10月至2019年10月于河北医科大学第二医院心内科收治的PAH患者78例。根据肺动脉收缩压(sPAP)分为轻度28例,中度31例和重度19例。采用TTE和RHC测量PAH患者血流动力学参数,比较两者的相关性。结果 TTE与RHC检查在慢性阻塞性肺病相关性PAH患者数量中,差异有统计学意义(P<0.05)。TTE测量sPAP、肺动脉舒张压(dPAP)、平均肺动脉压(mPAP)、右心输出量(RCO)与RHC之间具有较好的相关性(r=0.773,0.759,0.693,0.802;P<0.05)。轻度PAH患者TTE测量sPAP、dPAP、mPAP、RCO与RHC间呈低相关(r=0.495,0.472,0.429,0.518;P<0.05)。中度PAH患者TTE测量sPAP、dPAP、mPAP、RCO与RHC间呈高相关(r=0.841,0.826,0.785,0.873;P<0.05)。重度PAH患者TTE测量sPAP、dPAP、mPAP、RCO与RHC之间呈中度相关(r=0.796,0.751,0.729,0.814;P<0.05)。结论 TTE和RHC评估PAH患者的血流动力学参数测值具有较好的相关性,但两者在不同病因和不同病情患者中具有差异。TTE作为诊断PAH的无创检查方法,值得临床推广应用。更多还原

【Abstract】 Objective To discuss the value of transthoracic echocardiogram (TTE) and right heart catheterization (RHC) in reviewing hemodynamic parameters in patients with pulmonary arterial hypertension (PAH).Methods PAH patients (n=78) were chosen from Department of Cardiology in the Second Hospital of Hebei Medical University from Oct.2017 to Oct.2019.All patients were divided,according to systolic pulmonary arterial pressure (sPAP),into mild PAH group (n=28),moderate PAH group (n=31) and severe PAH group (n=19).The hemodynamic parameters were detected by using TTE and RHC,and compared the correlation among hemodynamic parameters,TTE and RHC.Results The difference in number of PAH patients related to chronic obstructive pulmonary disease had statistical significance between TTE and RHC (P<0.05).There was a better correlation between TTE and RHC in detecting sPAP (r=0.773),diastolic pulmonary artery pressure (dPAP,r=0.759),mean pulmonary arterial pressure (mPAP,r=0.693) and right cardiac output (RCO,r=0.802,P<0.05).There was a lower correlation between PAH and TTE in detecting sPAP (r=0.495),dPAP (r=0.472),mPAP (r=0.429) and RCO (r=0.518) in mild PAH group (P<0.05).There was a higher correlation between TTE and RHC in detecting sPAP (r=0.841),dPAP (r=0.826),mPAP (r=0.785) and RCO (r=0.873) in moderate PAH group (P<0.05).There was a moderate correlation between TTE and RHC in detecting sPAP (r=0.796),dPAP (r=0.751),mPAP (r=0.729) and RCO (r=0.814) in severe PAH group (P<0.05).Conclusion TTE and RHC have good correlation in reviewing hemodynamic parameters in PAH patients,but the correlation between TTE and RHC is different in patients with different causes and different conditions.TTE,as a noninvasive method for PAH diagnosis,is worthy of clinical application.更多还原