CAJ | 학술논문

目的：探讨超声心动图组织多普勒T ei指数在评价肺动脉高压模型兔右心功能方面的应用价值，并分析尼可地尔对肺动脉高压所致的右心功能减退是否有缓解作用。方法研究对象为33只雄性新西兰白兔随机分为三组：I组，肺动脉高压模型组（肺动脉收缩压＞30mmHg）；II组，尼可地尔组；III组，空白对照组（肺动脉收缩压≤30mmHg）。对所有模型测定右心功能超声指标，比较各组间指标的差别，分析右室T ei指数对右心功能的影响。取标准心尖四腔观，测量右室收缩期右房室环最大运动速率（Sm）、舒张早期最大运动速率（Em）、舒张晚期最大运动速率（Am）和Em/Am值，以及ET ，计算右室Tei指数。结果肺高压组（I组）右室Em下降，Am增高，Em/Am比值降低。与正常对照组（III组）相比，肺高压组（I组）右室T ei指数明显升高（ P ＜0．01），与正常对照组（III组）相比，尼可地尔组（II组）右室 T ei指数明显升高（ P＜0．01）。肺高压组（I组）与尼可地尔组（II组）相比，肺高压组（I组） T ei指数较高，差异有统计学意义（ P ＜0．05）。结论利用TDI技术测量右心Tei指数对右心功能不全患者可无创、迅速地评价其右心室功能，对指导临床治疗具有较高的应用价值。尼可地尔对改善由肺动脉高压导致的右心功能减退亦有一定的疗效。
목적：탐토초성심동도조직다보륵T ei지수재평개폐동맥고압모형토우심공능방면적응용개치，병분석니가지이대폐동맥고압소치적우심공능감퇴시부유완해작용。방법연구대상위33지웅성신서란백토수궤분위삼조：I조，폐동맥고압모형조（폐동맥수축압＞30mmHg）；II조，니가지이조；III조，공백대조조（폐동맥수축압≤30mmHg）。대소유모형측정우심공능초성지표，비교각조간지표적차별，분석우실T ei지수대우심공능적영향。취표준심첨사강관，측량우실수축기우방실배최대운동속솔（Sm）、서장조기최대운동속솔（Em）、서장만기최대운동속솔（Am）화Em/Am치，이급ET ，계산우실Tei지수。결과폐고압조（I조）우실Em하강，Am증고，Em/Am비치강저。여정상대조조（III조）상비，폐고압조（I조）우실T ei지수명현승고（ P ＜0．01），여정상대조조（III조）상비，니가지이조（II조）우실 T ei지수명현승고（ P＜0．01）。폐고압조（I조）여니가지이조（II조）상비，폐고압조（I조） T ei지수교고，차이유통계학의의（ P ＜0．05）。결론이용TDI기술측량우심Tei지수대우심공능불전환자가무창、신속지평개기우심실공능，대지도림상치료구유교고적응용개치。니가지이대개선유폐동맥고압도치적우심공능감퇴역유일정적료효。
Objective To investigate the application value of tissue Doppler echocardiography Tei index in the evaluation of right heart function in a rabbit model of pulmonary hypertension ,and to analyze whether nicorandil had a relief effect on pulmonary hypertension caused by right ventricular dysfunction .Methods The subjects were 33 male New Zealand white rabbits ,which were randomly divided into three groups :group I ,pulmonary hypertensive model group ,(pulmonary ar-tery systolic pressure>30 mmHg);group II ,nicorandil-treated group ;group III ,blank control group (pulmonary vaso-constriction pressure ≤30 mmHg) .The parameters of echocardiography regarding the right ventricular function for for all models were detected ,the differences of these indicators between the groups were compared ,and the effects of right ven-tricular Tei index on right ventricular function were analyzed .The standard apical four -chamber view were taken ,the maximum movement velocity (Sm) of right atrioventricular ring at right ventricular systolic stage ,the maximal exercise (Em) at early diastolic stage ,the maximum moving speed (Am) at late diastolic stage ,and the Em/Am values were meas-ured .Also ,ET and right ventricular Tei index were calculated Results In group I ,Em was decreased ,Am was in-creased ,and Em/Am ratio was decreased .Compared with that in group III ,the right ventricular Tei index in group I was significantly higher ( P<0 .01) and compared with that in group III ,the right ventricular Tei index in group II was signif-icantly higher ( P<0 .01) .Compared with that in group II ,the Tei index in group I was higher ,the difference was statis-tically significant ( P<0 .05) .Conclusion TDI technology for measuring right ventricular Tei index in patients with right ventricular dysfunction may be noninvasive ,which can rapidly evaluate right ventricular function and has a high application value in clinical treatment .Nicorandil has a certain effect on improving pulmonary hypertension caused by a right heart dysfunction .