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目的探讨实时三维超声心动图(RT-3DE)在急性肺栓塞(APE)患者右心室功能中的应用价值。方法 110例APE患者进行危险分层,分为APE高危组(36例)、APE中危组(39例)、APE低危组(35例),同期35例健康体检者作为对照组。应用RT-3DE测算比较右心室横径(RV)、肺动脉收缩压(SPAP)、右心室舒张末期容积(RVEDV)、每搏量(RVSV)、右心室射血分数(RVEF)、右心室峰值排空率(PER)、右心室Tei指数。结果与对照组和APE低危组、中危组比较,APE高危组RV、SPAP、RVEDV和Tei显著升高(P<0.05),RVEF和PER显著降低(P<0.05)。校正心率后,Tei[OR=5.596,95%CI=(1.599,19.579),P=0.007<0.05]和SPAP[OR=1.870,95%CI=(1.171,2.988),P=0.009<0.05]仍能进入回归方程,提示两者是APE危险分层的独立危险因素。结论 Tei指数和SPAP是评价APE右心室功能的较好指标,可以用于危险分层。
Objective To investigate the value of real-time three-dimensional echocardiography (RT-3DE) in right ventricular function in patients with acute pulmonary embolism (APE). Methods One hundred and ten patients with APE were divided into high risk group (36 cases), APE moderate risk group (39 cases), APE low risk group (35 cases) and 35 healthy subjects as control group. RV-RVP, SPAP, RVEDV, RVSV, RVEF and right ventricular peak were measured by RT-3DE. Rate of heart rate (PER), Tei index of right ventricle. Results The RV, SPAP, RVEDV and Tei in high risk APE group were significantly increased (P <0.05) and RVEF and PER were significantly lower than those in control group and low risk APE group (P <0.05). Tei [OR = 5.596,95% CI = (1.599, 19.579), P = 0.007 <0.05] and SPAP [OR = 1.870,95% CI = (1.171,2.988), P = 0.009 <0.05] after correction of heart rate Can enter the regression equation, suggesting that both are independent risk factors for risk stratification of APE. Conclusions Tei index and SPAP are good indicators to evaluate APE right ventricular function and can be used for risk stratification.