CAJ | 학술논문

目的：应用二维斑点追踪成像技术评价肺动脉高压患者右心室收缩功能，并与实时三维超声心动图进行对比研究。方法肺动脉高压患者31例，正常对照组33例，常规超声心动图测量各房室腔的大小、右心室游离壁厚度；二维斑点追踪成像技术获得右心室各个节段纵向应变、应变率及运动速度；应用实时三维超声心动图测量右心室射血分数。结果与对照组相比，肺动脉高压组右心室游离壁、室间隔基底段及中间段收缩期峰值运动速度较正常对照组减低（P<0.05）；右心室各段收缩期应变除了心尖段外，其余各段较对照组减低（P<0.05）；右心室应变率除室间隔侧心尖段外，其余各段差异均有统计学意义（P<0.05）；右心室游离壁、室间隔收缩期峰值纵向应变平均值与肺动脉收缩压、三件瓣环收缩期位移、右心室射血分数有较好的相关性（P<0.01）。结论斑点追踪成像技术各参数与多普勒超声心动图、三维超声心动图测量肺动脉收缩压及射血分数呈较好的相关性，为临床提供了一种新的方法评价肺动脉高压患者右心室收缩功能。
목적：응용이유반점추종성상기술평개폐동맥고압환자우심실수축공능，병여실시삼유초성심동도진행대비연구。방법폐동맥고압환자31례，정상대조조33례，상규초성심동도측량각방실강적대소、우심실유리벽후도；이유반점추종성상기술획득우심실각개절단종향응변、응변솔급운동속도；응용실시삼유초성심동도측량우심실사혈분수。결과여대조조상비，폐동맥고압조우심실유리벽、실간격기저단급중간단수축기봉치운동속도교정상대조조감저（P<0.05）；우심실각단수축기응변제료심첨단외，기여각단교대조조감저（P<0.05）；우심실응변솔제실간격측심첨단외，기여각단차이균유통계학의의（P<0.05）；우심실유리벽、실간격수축기봉치종향응변평균치여폐동맥수축압、삼건판배수축기위이、우심실사혈분수유교호적상관성（P<0.01）。결론반점추종성상기술각삼수여다보륵초성심동도、삼유초성심동도측량폐동맥수축압급사혈분수정교호적상관성，위림상제공료일충신적방법평개폐동맥고압환자우심실수축공능。
Objective To evaluate right ventricular systolic function with two dimensional speckle tracking imaging echocardiography in patients with pulmonary hypertension and compare with the results of real-time three-dimensional echocardiography. Methods This study included 31 cases of pulmonary hypertension patients and 33 healthy cases regarded as control group. Routine parameters such as the dimension of right ventricular, the thickness of right ventricular free wall and the maximal velocity of tricuspid valve regurgitation were measured by conventional echocardiography. Strain parameters such as the longitudinal strain, strain rate and movement speed of right ventricular various segments were measured by speckle tracking imaging echocardiography. Right ventricular ejection fraction was measured by real-time three-dimensional echocardiography. Results Compared with the control group, systolic peak velocity of right ventricular free wall, ventricular septal basal segment and the middle segment in pulmonary hypertension group was lower(P<0.05). Systolic strain and strain rate of right ventricular were lower than that of the control group;Systolic strain between every segment of right ventricular was statistically significant(P<0.05)except the apical segment, right ventricular strain rate between two segments were statistically significant(P<0.05)except apical segment of the interventricular septum side. Both average strain values of right ventricular free wall and interventricular septum were correlated with pulmonary artery systolic pressure and systolic displacement of tricuspid ring also correlated well with RVEF measured by speckle tracking imaging. Conclusion Speckle tracking imaging show a good correlation with routine doppler echocardiography measurement pulmonary artery systolic pressure and RVEF and would provide a new way to evaluate pulmonary hypertension.