【摘要】 目的应用二维斑点追踪成像(2D-STI)评价慢性阻塞性肺疾病(COPD)早期右室收缩功能。方法选取COPD患者150例作为COPD组,其中70例COPD无肺动脉高压亚组,80例COPD合并肺动脉高压亚组。选取健康志愿者80例为健康组。比较三组右室基底段内径(RVED)、右室游离壁厚度(RVFW)、右室面积变化分数(FAC)、右室三尖瓣环收缩期位移(TAPSE)、右室心肌做功指数(RIMP)、右室收缩期长轴整体应变(GLS)及右心室各节段的收缩期长轴峰值应变,基底段、中间段、心尖段游离壁(S1～S3)、室间隔(S4～S6),分析右室各节段应变与GLS相关性。结果 COPD组、COPD无肺动脉高压亚组和COPD合并肺动脉高压亚组的RIMP明显高于健康组(P<0.05),COPD合并肺动脉高压亚组的RIMP明显高于COPD无肺动脉高压亚组(P<0.05),三组的RVFW、RVED、FAC和TAPSE差异无统计学意义(P>0.05)。COPD组的GLS、S1～S6均明显低于健康组(P<0.05),COPD合并肺动脉高压亚组的GLS、S1～S6均明显低于COPD无肺动脉高压亚组(P<0.05)。GLS与S1～S6间均存在相关性(r=0.654、0.515、0.483、0.231、0.434、0.497,P<0.05),其中与S1的相关系数最高。结论与传统的超声心动图技术相比,2D-STI技术可敏感地定量评估COPD患者早期右室局部及整体收缩功能。更多还原

【Abstract】 Objective To apply 2-dimensional speckle tracking imaging(2 D-STI) to evaluate right ventricular systolic function in patients with early chronic obstructive pulmonary disease(COPD). Methods 150 patients with COPD admitted to our hospital were collected into our study as the COPD group, including 70 cases of COPD without pulmonary hypertension and 80 cases of COPD with pulmonary hypertension. And 80 healthy volunteers were selected as the healthy group. The right ventricular end-diastolic diameter(RVED), right ventricular free wall thickness(RVFW), fractional area change(FAC), right ventricle tricuspid annular plane systolic excusion(TAPSE), right ventricular index of myocardal performance(RIMP), right ventricular systolic global longitudinal strain(GLS), and each segment of the right ventricle period long axis peak strain, basal segment, middle segment, apical segment free wall(S1-S3), interventricular septum(S4～S6) of the COPD group(COPD without pulmonary hypertension subgroup and COPD with pulmonary hypertension subgroup) and the healthy group were compared. The correlation between the strain of each segment of the right ventricle and GLS were analyzed. Results The RIMP of the COPD group, COPD without pulmonary hypertension subgroup and COPD with pulmonary hypertension subgroup was significantly higher than that of the healthy group(P<0.05) The RIMP of COPD with pulmonary hypertension subgroup was significantly higher than that of COPD without pulmonary hypertension subgroup(P<0.05). There was no statistically significant difference in RVFW, RVED, FAC and TAPSE among 4 groups(P>0.05). The GLS and S1-S6 of 2 COPD subgroups were significantly lower than those of the healthy group(P<0.05), and the GLS and S1-S6 of COPD combined with pulmonary hypertension group were significantly lower than those of COPD without pulmonary hypertension group(P<0.05). There as a correlation between GLS and S1-S6(r=0.654, 0.515, 0.483, 0.231, 0.434, 0.497, P<0.05), and the correlation coefficient of S1 was the highest. Conclusions Compared with conventional echocardiography, 2 D-STI technique is more sensitive than to quantitatively assess the early right ventricular local and overall systolic function in COPD patients.更多还原