【摘要】 目的探讨脉冲组织多普勒(PW-TDI)评价肝硬化失代偿期右心功能的临床价值。方法正常对照组及肝硬化失代偿期门脉高压患者各20例,行常规超声心动图检查测量左室舒张末期内径和左房收缩末期内径(LVDd,LADs),右室舒张末期内径和右房收缩末期内径(RVDd,RADs),并应用PW-TDI技术测量三尖瓣前叶瓣环(ATA)隔叶瓣环(STA)及后叶瓣环处(PTA)舒张早期舒张晚期心肌运动速度(E′和A′)及E′/A′比值,同时测量三尖瓣前叶瓣环处心肌收缩期S波持续时间(systolic duration time S-dT)。结果肝硬化患者ATA、STA及PTA处舒张早期心肌运动速度E′较正常对照组均明显降低(P<0.01、P<0.05及P<0.01)肝硬化患者ATA及PTA处舒张晚期心肌运动速度A′均明显增加(P均<0.05),肝硬化患者STA处舒张晚期心肌运动速度A′亦增加,但与正常对照组比较差别无统计学意义(P>0.05)。肝硬化患者ATA、STA及PTA处E′/A′比值较正常对照组均明显降低(P均<0.01)。肝硬化患者ATA处S-dT明显缩短(P<0.05)。结论肝硬化失代偿期患者右心舒张功能受损,S波持续时间缩短,PW-TDI可简便、敏感地反映肝硬化患者的右心功能。更多还原

【Abstract】 Objective To investigate the value of PW-TDI for estimating right ventricular function in the patients with hepatic cirrhosis.Methods Twenty cases with hepatic cirrhosis in decompensation stage and 20 healthy persons were involved in this study.The diastolic diameters of left and right ventricles(LVDd,RVDd)and the systolic diameters of left and right atria(LADs,RADs)were measured by conventional echocardiography.E′and A′at the anterior,septal and posterior triuspid annuli(ATA,STA,PTA) and systolic duration time (S-dT) at the anterior triuspid annulus(ATA) were measured with PW-TDI.Results All E’s were decreased obviously at ATA、STA and PTA in patients with hepatic cirrhosis as compared with those of the healthy group(P<0.01、P<0.05 and P<0.01 respectively),Both A′were increased obviously at ATA and PTA(all compared with the healthy,P<0.05).A′was also increased at STA,but there was no obvious significance(P>0.05 ).All E′/ A′ratios were decreased obviously at ATA、STA and PTA (all P<0.01)。S-dT was decreased significantly(P<0.05).Conclusions In the decompensation stage of patients with hepatic cirrhosis,the right ventricular diastolic function was affected,the S-dt was shortened.TDI was valuable and easy for estimating right ventricular functions with high sensitivity in patients with hepatic cirrhosis in decompensation.更多还原