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目的:运用超声心动图评价肺栓塞(PE)患者右心室功能及形态的改变,并对其准确性、敏感性及优越性予以进一步的探讨。方法:采用超声心动图,对我院2013-09-2015-09收治的90例正常健康者(正常对照组)和90例PE患者(PE组)的右心室功能进行测定,并对2组患者的临床资料进行回顾性分析。PE组又依据预期的PE相关早期病死率进行危险分层,分为高危组、中危组、低危组。正常对照组和PE组患者均进行右心室常规超声指标(心律、心率、呼吸、血压等)、右心室Tei指数及右心室舒张期末容积(RVEDV)、收缩期末容积(RVESV)、每搏输出量(RVSV)和射血分数(RVEF)的检测,比较2组患者的检测结果。结果:与正常对照组比较,PE高危组患者的右心室横径(RV)、右心房横径(RA)显著增大,且SPAP有显著升高的趋势(P<0.05)。另外,高危组患者的右心室Tei指数、RVEDV及RVESV水平均显著高于正常对照组(P<0.05),但其RVEF水平显著低于正常对照组(P<0.05);中危组RV、RA无显著增大,但右心室Tei指数、RVEDV、RVESV、RVEF均出现了一定的异常(P<0.05);低危组的各项测定指标与正常对照组比较差异均无统计学意义。结论:采用超声心动图对PE患者的右心室功能进行测定,可发现PE对患者的右心室功能造成不同程度的损伤。保证右心室Tei指数以及RVEF水平的检测结果的真实有效,则可以准确客观的反映出PE患者的右心室功能变化情况。因此,超声心动图检查是一种较好的评价PE患者右心室功能的检查方法和手段。
OBJECTIVE: To evaluate the changes of right ventricular function and morphology in patients with pulmonary embolism (PE) by echocardiography and to further investigate its accuracy, sensitivity and superiority. Methods: Echocardiography was used to determine the right ventricular function in 90 healthy controls (normal control group) and 90 PE patients (PE group) treated in our hospital from September 2013 to September 2015. The right ventricular function was measured in two groups The clinical data were retrospectively analyzed. The PE group was further stratified according to the expected PE-related early mortality and divided into high risk group, moderate risk group and low risk group. Normal control group and PE group were performed routine right ventricular ultrasound parameters (heart rate, heart rate, respiration, blood pressure, etc.), right ventricular Tei index and right ventricular end-diastolic volume (RVEDV), systolic volume (RVESV) (RVSV) and ejection fraction (RVEF) were measured, and the results of two groups of patients were compared. Results: Compared with the normal control group, the right ventricular diastolic dimension (RV) and the right atrial diameter (RA) were significantly increased in patients with high risk of PE, and the SPAP was significantly increased (P <0.05). In addition, the levels of Tei index, RVEDV and RVESV in the right ventricle were significantly higher in the high-risk group than those in the normal control group (P <0.05), but the levels of RVEF in the high-risk group were significantly lower than those in the normal control group (P <0.05) (P <0.05). However, there was no significant difference between the low-risk group and the normal control group in Tei index, RVEDV, RVESV and RVEF. Conclusion: The echocardiographic measurement of right ventricular function in patients with PE, PE can be found on the right ventricular function in patients with varying degrees of damage. To ensure the right ventricular Tei index and RVEF levels of the true and effective test results, you can accurately and objectively reflect the changes in patients with PE right ventricular function. Therefore, echocardiography is a good method to evaluate the right ventricular function in PE patients.