CAJ | 학술논문

目的：探讨超声心动图技术对急性肺栓塞治疗效果的评价作用。方法选择我院诊治的急性肺栓塞48例，分别于治疗前，治疗后3、6、12个月做超声心动图检查，测量指标包括右室横径（RVD）、左室横径（LVD）、右房横径（RAD）、左房横径（ LAD）、肺动脉主干内径（ MPAD）、三尖瓣反流压差（ PGTR）、计算右房横径/左房横径（ RATD/LATD）、右室横径/左室横径（ RVD/LVD）及肺动脉收缩压（ SPAP）。比较以上指标在不同时点的变化。结果在溶栓和（或）抗凝治疗3个月时，SPAP [（38．64±11．33）vs（49．86±19．61）]、RA/LA[（1．01±0．28）vs（1．11±0．33）]与治疗前比较，改善最为明显（均P＜0．01）；至6个月、12个月时，改善幅度变小。在溶栓和（或）抗凝治疗3、6、12个月时，RV/LV与治疗前比较，均有明显改善（ P＜0．01或P＜0．05）；而MPAD、LVEF在治疗前后，以及随诊观测中均没有变化，差异无统计学意义（P＞0．05）。全部患者随访12个月后，4例进展为慢性血栓栓塞性肺动脉高压（ chronic thromboembolic pulmonary hypertension ，CTEPH）。结论超声心动图可以作为评价急性肺栓塞疗效的无创实用技术。
목적：탐토초성심동도기술대급성폐전새치료효과적평개작용。방법선택아원진치적급성폐전새48례，분별우치료전，치료후3、6、12개월주초성심동도검사，측량지표포괄우실횡경（RVD）、좌실횡경（LVD）、우방횡경（RAD）、좌방횡경（ LAD）、폐동맥주간내경（ MPAD）、삼첨판반류압차（ PGTR）、계산우방횡경/좌방횡경（ RATD/LATD）、우실횡경/좌실횡경（ RVD/LVD）급폐동맥수축압（ SPAP）。비교이상지표재불동시점적변화。결과재용전화（혹）항응치료3개월시，SPAP [（38．64±11．33）vs（49．86±19．61）]、RA/LA[（1．01±0．28）vs（1．11±0．33）]여치료전비교，개선최위명현（균P＜0．01）；지6개월、12개월시，개선폭도변소。재용전화（혹）항응치료3、6、12개월시，RV/LV여치료전비교，균유명현개선（ P＜0．01혹P＜0．05）；이MPAD、LVEF재치료전후，이급수진관측중균몰유변화，차이무통계학의의（P＞0．05）。전부환자수방12개월후，4례진전위만성혈전전새성폐동맥고압（ chronic thromboembolic pulmonary hypertension ，CTEPH）。결론초성심동도가이작위평개급성폐전새료효적무창실용기술。
Objective To evaluate the application of echocardiography technology for the treatment of acute pulmonary embol -ism effect evaluation .Methods Between February 2009 and November 2013,from departments of respiratory medicine and cardiology in Armed Police hospital , 48 patients with acute pulmonary embolism were recruited .In thrombolysis and anticoagulation therapy before and after treatment for 3 months,6 months and 12 months, echocardiography was conducted .Measure indicators including right ventric-ular diameter (RVD),left ventricular diameter(LVD),right atrial diameter (RAD), left atrial diameter (LAD),main pulmonary ar-tery diameter (MPAD), pressure gradient of tricuspid valve regurgitation (PGTR), right ventricular anterior wall motion (RVAWM), RVD/LVD、RAD/LAD and SPAP, were calculated.Results SPAP with RA/LA improvement was most obvious when anticoagulation in March .As time went on, change was not obvious .After anticoagulant treatment for 3 month and 6 month, the RV/LV obviously improved,there were still changes after treatment for 12 months.MPAD and EF had no changes before and after treatment and follow-up.After follow-up of all 48 patients for 12 months, 4 patients had chronic thromboembolic pulmonary hypertension .Conclusions Echocardiogaphy can be used as a practical technology for noninvasive evaluation of curative effect on acute pulmonary embolism .