[1]王全宏,蔡宇星△,徐 辉.心脏超声在重症监护室肺动脉高压患者肺血管压力和右心功能评估中的应用分析*[J].陕西医学杂志,2019,(7):863-866.
　WANG Quanhong,CAI Yuxing,XU Hui..Application of echocardiography in evaluation of pulmonary vascular pressure and right heart function in patients with pulmonary hypertension in intensive care unit[J].,2019,(7):863-866.
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心脏超声在重症监护室肺动脉高压患者肺血管压力和右心功能评估中的应用分析*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年7期
页码:
863-866
栏目:
临床研究
出版日期:
2019-07-05

文章信息/Info

Title:
Application of echocardiography in evaluation of pulmonary vascular pressure and right heart function in patients with pulmonary hypertension in intensive care unit
文章编号:
DOI:10.3969/j.issn.1000-7377.2019.07.013
作者:
王全宏1; 蔡宇星2△;  徐 辉
1.解放军537医院特诊科（宝鸡721000）；2.陕西省宝鸡市中心医院呼吸内科（宝鸡721000）
Author(s):
WANG Quanhong;  CAI Yuxing; XU Hui.
Special Diagnosis Department of 537 Hospital of PLA （Baoji 721000）
关键词:
肺动脉高压; 超声检查; 心脏; 便携式; 肺血管压; 右心功能
Keywords:
Key words Pulmonary hypertension; Ultrasound; Heart; Portable; Pulmonary vascular pressure; Right heart function
分类号:
R540.45
文献标志码:
A
摘要:
摘 要 目的：探讨心脏超声在重症监护室（ICU）肺动脉高压（PAH）患者肺血管压力及右心功能评估中的价值。方法：选择ICU内疑似存在右心功能障碍31例并发PAH（观察组）患者和35例非PAH（对照组）患者作为研究对象。患者均采用便携式彩色多普勒超声诊断仪对胸骨旁大动脉轴切面和心尖四腔心切面做重点观察。对比两组肺动脉主干直径、右肺动脉直径、肺动脉收缩压（PAPS）、肺动脉舒张压（RADP）、肺动脉平均值（PAPm）、右心室射血分数（RVEF）、右心室面积变化率（RVFAC）、三尖瓣环收缩期移位（TAPSE）、右心室心肌功能Tei指数（RV Tei）及E/A心脏超声检测结果。结果：方差分析显示，对照组与观察组各亚组患者肺动脉主干直径、右肺动脉直径、PAPs、RADP、PAPm、RVEF、RVFAC、RV Tei指数及E/A值间比较，差异均存在统计学意义（P＜0.05）。SKN-q检验显示，观察组轻度亚组患者肺动脉主干直径、右肺动脉直径、PAPs、RADP、PAPm、RV Tei指数及E/A值大于对照组，中度亚组显著大于轻度亚组，重度亚组显著高于中度亚组（P＜0.05）；而观察组RVEF、RVFAC超声诊断值小于对照组，中度亚组显著小于轻度亚组，重度亚组显著小于中度亚组（P＜0.05）。独立样本t检验显示，观察组总体肺动脉主干直径、右肺动脉直径、PAPs、RADP、PAPm、RV Tei指数及E/A值均显著高于对照组，RVEF、RVFAC显著低于对照组（P＜0.05）。而各组TAPSE超声测定值间比较，差异无统计学意义（P＞0.05）。结论：便携式心脏超声检查可实时客观的反应PAH患者肺血管压及右心功能状态，为临床PAH的临床筛查及治疗提供有效信息。
Abstract:
Abstract Objective: To investigate the value of echocardiography in the evaluation of pulmonary vascular pressure and right heart function in patients with pulmonary hypertension (PAH) in intensive care unit (ICU).Methods: From January 2017 to December 2018，31 patients with suspected right heart dysfunction and PAH (observation group) and 35 non-PAH (control group) patients were selected as subjects. The patients were treated with a portable color Doppler ultrasound system for the parasternal aorta axis and apical four-chamber view. The pulmonary artery diameter，right pulmonary artery diameter，PAPs，RAPD，PAPm，RVEF，RVFAC，TAPSE，RV Tei index and E/A echocardiography were compared between the two groups.〖HTSS〗Results:Analysis of variance showed that there were statistically significant differences in pulmonary artery diameter，right pulmonary artery diameter，PAPs，RAPD，PAPm，RVEF，RVFAC，RV Tei index and E/A between the control group and the observation group (P＜0.05).The SKN-q test showed，compared with the control group,the pulmonary artery diameter，right pulmonary artery diameter，PAPs，RAPD，PAPm，RV Tei index and E/A values were significantly greater in the observation group;and the moderate subgroup was significantly larger than the mild subgroup. The severe subgroup was significantly higher than the moderate subgroup(P＜0.05);the ultrasound diagnosis of RVEF and RVFAC in the observation group was smaller than that of the control group，the moderate subgroup was significantly smaller than the mild〖LM〗subgroup，and the severe subgroup was significantly smaller than the moderate subgroup(P＜0.05).Independent sample t-test showed that the total pulmonary artery diameter，right pulmonary artery diameter，PAPs，RAPD，PAPm，RV Tei index and E/A value were significantly higher in the observation group than in the control group，and RVEF and RVFAC were significantly lower than the control group (P＜0.05). ). There was no significant difference between the TAPSE ultrasound measurements in each group (P＞0.05).Conclusion: Portable echocardiography can reflect the pulmonary vascular pressure and right heart function status of PAH patients in real time and objectively，providing effective information for clinical screening and treatment of clinical PAH.

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备注/Memo

备注/Memo:
*陕西省科技攻关项目(2012K19-01)
更新日期/Last Update: 2019-07-12