超声心动图对慢性高原病患者右心室结构及功能的初步研究

王俊宝; 马淑梅; 才让卓玛; 杨建华; 晁丽

doi:10.13201/j.issn.1001-1439.2019.03.020

超声心动图对慢性高原病患者右心室结构及功能的初步研究

- 青海大学附属医院超声医学科(西宁, 810000)

详细信息

通讯作者: 马淑梅,E-mail:764273542@qq.com

中图分类号: R540.4

收稿日期: 2018-09-26

修回日期: 2018-10-17

Preliminary study of right ventricular structure and function in patients with chronic high-altitude disease by echocardiography

- Department of Ultrasound Medicine, Affiliated Hospital of Qinghai University, Xining, 810000, China

More Information

Corresponding author: MA Shumei, E-mail: 764273542@qq.com

Received Date: 26 September 2018

Revised Date: 17 October 2018

摘要

摘要: 目的：应用超声心动图检测慢性高原病（chronic mountain sickness，CMS）患者右心室结构与功能变化并探究其临床实用价值。方法：收集29例CMS患者（CMS组）和来自同一海拔高度的29名健康成人志愿者（对照组）作为研究对象，应用超声心动图分别做以下检测：舒张期室间隔厚度（IVSd）、舒张期右室前壁厚度（RVAWd）、舒张期右心室左右径（RV）、三尖瓣收缩期位移（TAPSE）、右心室面积变化分数（FAC）、右心室Tei指数及舒张期主肺动脉（MPA）的宽度，舒张期三尖瓣血流E峰与A峰比值（E/A）、根据三尖瓣返流束的峰值流速（TR）估测主肺动脉的收缩压（PASP）。最后统计所得到的数据，分析CMS对人体右心功能造成的影响。结果：①右心室结构参数：CMS组的RVAWd和RV与对照组比较均有所增加，差异有统计学意义（P<0.05）；CMS组IVSd与对照组相比无明显变化，差异无统计学意义（P>0.05）。②右心室功能参数：CMS组Tei指数跟对照组相比有上升趋势，而CMS组E/A值、TAPSE和FAC相比对照组有明显减低（均P<0.05）。③主肺动脉参数：与对照组相比，CMS患者MPA明显增加，PASP明显增高，差异均有统计学意义（均P<0.05）。④随着居住年限的增加，CMS患者IVSd无明显改变，差异无统计学意义（P>0.05）；而RVAWd、RV、MPA、PASP和Tei指数均会随着居住时间的增加有所增加，E/A、TAPSE和FAC出现逐渐减低的趋势，差异均有统计学意义（P<0.05）。结论：CMS患者的右心室壁增厚、室腔增大以及收缩和舒张功能均有下降趋势，且以上结构与功能的改变随时间的延长均趋向恶化；CMS患者室间隔未见明显改变，可能是因为左心代偿作用所致。超声心动图在评估CMS患者右心室结构及功能方面具有较高实用价值。
- 超声心动图 /
- 慢性高原病 /
- 右心室 /
- 结构与功能 /
- 主肺动脉
Abstract: Objective: To detect the structural and functional changes of right heart function in patients with chronic mountain sickness (CMS) by echocardiography and to explore its clinical value.Method: Twenty-nine patients with CMS (CMS group) and 29 healthy adult volunteers (control group) from the same altitude were enrolled as subjects. The following parameters were measured using echocardiography:diastolic ventricular septal thickness (VISd), diastolic right ventricular anterior wall thickness (RVAWd), diastolic right ventricle (RV) left and right diameter, tricuspid systolic displacement (TAPSE), right ventricular area change score (FAC), right ventricular Tei index, and diastolic primary pulmonary artery (MPA) width of the diastolic tricuspid blood flow E peak to peak A ratio (E/A), according to the peak flow velocity (TR) of the tricuspid regurgitation beam estimated systolic pulse of the systolic pressure (PASP).Finally, the data obtained from the statistics were used to analyze the effects of chronic altitude sickness on the right heart function of the human body.Result: ①Right ventricular structural parameters, RVAWd and RV in CMS group were increased compared with the control group, the difference was statistically significant, P<0.05;but the difference in IVSddid not reach significance between two groups (P>0.05).②Compared with control group, right ventricular function parameter, the Tei index of CMS group was increased, while the E/A value, TAPSE and FAC were decreased (P<0.05).③ Compared with the control group, main pulmonary artery parameters MPA, CMS, and PASP were all significantly increased in CMS group (P<0.05).④With the increase of years of residence, there was no significant change in IVSd of CMS patients, the difference was not statistically significant (P>0.05);while RVAWd, RV, MPA, PASP and Tei index increased with the increase of residence time.E/A, TAPSE and FAC showed a trend of decreasing gradually, and the difference was statistically significant (P<0.05).Conclusion: The right ventricular wall thickening, chamber enlargement, and systolic and diastolic function of CMS patients have a decreasing trend.The above structural and functional changes tend to deteriorate with time in CMS group, but there is no obvious change in the interventricular septum possible due to the left heart compensation. Echocardiography has high practical value in evaluating the structure and function of right ventricle in patients with CMS.
- echocardiography /
- chronic mountain sickness /
- right ventricle /
- structure and function /
- main pulmonary artery

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