CAJ | 학술논문

目的探讨三尖瓣环收缩期位移（TAPSE）评价房间隔缺损（ASD）患者右心室收缩功能的价值。方法选取单纯继发孔型ASD患者41例，分为无肺动脉高压组26例和肺动脉高压组15例，另选取21例体检健康者为对照组。应用二维超声测量并计算右心室短轴缩短分数和长轴缩短分数，M型超声测量三尖瓣侧瓣环收缩期位移，实时三维超声测量右心室射血分数（RVEF）。将TAPSE与右心室长轴缩短分数、RVEF做相关性分析。结果3组右心室长轴缩短分数均大于右心室短轴缩短分数（P＜0.05）；ASD无肺动脉高压组TAPSE、右心室长轴缩短分数及RVEF高于对照组和ASD并肺动脉高压组（P＜0.05）；ASD并肺动脉高压组与对照组间的TAPSE、右心室长轴缩短分数和RVEF比较差异无统计学意义（P＞0.05）；3组TAPSE与右室长轴缩短分数、RVEF均呈正相关（P＜0.05）。结论 TAPSE能简便评价右心室收缩功能；ASD无肺动脉高压患者的右心室收缩功能增强，ASD并肺动脉高压患者的右心室收缩功能逐渐减低。
목적탐토삼첨판배수축기위이（TAPSE）평개방간격결손（ASD）환자우심실수축공능적개치。방법선취단순계발공형ASD환자41례，분위무폐동맥고압조26례화폐동맥고압조15례，령선취21례체검건강자위대조조。응용이유초성측량병계산우심실단축축단분수화장축축단분수，M형초성측량삼첨판측판배수축기위이，실시삼유초성측량우심실사혈분수（RVEF）。장TAPSE여우심실장축축단분수、RVEF주상관성분석。결과3조우심실장축축단분수균대우우심실단축축단분수（P＜0.05）；ASD무폐동맥고압조TAPSE、우심실장축축단분수급RVEF고우대조조화ASD병폐동맥고압조（P＜0.05）；ASD병폐동맥고압조여대조조간적TAPSE、우심실장축축단분수화RVEF비교차이무통계학의의（P＞0.05）；3조TAPSE여우실장축축단분수、RVEF균정정상관（P＜0.05）。결론 TAPSE능간편평개우심실수축공능；ASD무폐동맥고압환자적우심실수축공능증강，ASD병폐동맥고압환자적우심실수축공능축점감저。
Objective To investigating the value of tricuspid annular plane systolic excursion (TAPSE)in evaluating right ventricular function in patients with atrial septal defect (ASD) . Methods Forty-one patients with isolated secundum ASD and 21 controls were included. The patients were divided into normal pressure group (group 1) with 26 patients and pulmonary hypertension group (group 2) with 15 patients according to the level of pulmonary artery pressure. All underwent 2D,M mode and single beat real-time echocardiography imaging. Right ventricular short axis shortening fraction, right ventricular long axis shortening fraction,TAPSE and right ventricaular ejection fraction(RVEF)were measured and calculated. The correlation between TAPSE and right ventricular long axis shortening fraction and RVEF were analyzed. Results Right ventricular long axis shortening fraction was significantly higher than right ventricular short axis shortening fraction in the three groups (P < 0.05). TAPSE, right ventricular long axis shortening fraction and RVEF were significantly higher in group 1 than in group 2 and controls (P<0.05).Difference of TAPSE, right ventricular long axis shortening fraction and RVEF was not statistically significant between group 2 and controls (P>0.05). TAPSE was significant positive correlated with right ventricular long axis shortening fraction and RVEF in the three groups (P < 0.05). Conclusion TAPSE is a simple and fast method in evaluating right ventricular systolic function. Right ventricular systolic function increases in ASD patients with normal pulmonary artery pressure. Right ventricular systolic function reduces gradully in ASD patients complicated with pulmonary hypertension.