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目的运用超声心动图探讨不同右心构型功能性三尖瓣反流速度的测量切面。方法选取经胸超声心动图检查的功能性三尖瓣反流成人患者80例。根据右心房室大小分为右心大小正常组和右心增大组。多切面观察反流束方向,测量声束-反流束夹角(θ)以及三尖瓣反流速度(TRV)。结果 (1)在不同切面测量获取的TRV存在不一致性,67.5%位于1.96倍标准差区间之外。(2)TRVmax中θ角<20°占93.8%(75/80);胸骨旁四腔心平均θ值比心尖四腔切面更小(P<0.01)。(3)TR束具有多方向性,右心大小正常组中心性与偏心性反流频数差异无统计学意义(P>0.05),右心增大组以中心性反流为主(P<0.01)。(4)偏心性TRVmax主要集中于胸骨旁右室流入道长轴和胸骨旁四腔切面,偏心性TRV平均值在上述切面差异无统计学意义(P>0.05);中心性TRVmax主要集中于胸骨旁四腔切面,与其他切面比较,差异有统计学意义(P<0.01),中心性TRV平均值在该切面最大,差异有统计学意义(P<0.05)。结论分析不同右心构型TR特点,有助于经胸超声心动图选择TRV测量切面,提高测值准确度。
Objective To investigate the measurement of functional tricuspid regurgitation velocity in different right ventricular configurations by echocardiography. Methods Eighty patients with functional tricuspid regurgitation were selected by transthoracic echocardiography. According to the right atrium size is divided into normal right heart size group and right heart enlargement group. Multi-section view of the direction of the flow of the beam, measured beam - the angle of the beam (θ) and the tricuspid regurgitation velocity (TRV). Results (1) There were inconsistencies in the TRV measured at different sections, with 67.5% being outside the 1.96-fold SD range. (2) The angle θ <20 ° in TRVmax accounted for 93.8% (75/80). The mean value of θ in the four parasternal sternum was smaller than that in the apex quadriceps (P <0.01). (3) The TR bundle was multidirectional. There was no significant difference in the frequency of central and eccentric reflux between normal group and normal group (P <0.01) ). (4) The eccentricity of TRVmax mainly concentrated on the long axis of the parasternal right ventricle and the parasternal quadriceal section. There was no significant difference in eccentric TRV between these two sections (P> 0.05). The central TRVmax mainly concentrated on the sternum Compared with other sections, the difference was statistically significant (P <0.01). The average value of central TRV was the largest in this section, the difference was statistically significant (P <0.05). Conclusion The analysis of TR characteristics of different right ventricular configurations is helpful for the selection of TRV measurement transepithelial echocardiography to improve the accuracy of measurement.