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目的探讨超声心动图检测的肺循环血流动力学指标在尘肺病患者中的变化及其临床价值。方法采用单纯随机抽样方法,选取102例男性尘肺病患者,根据患者有无合并慢性肺源性心脏病(以下简称“肺心病”)分为单纯尘肺病组(70例)和尘肺病合并肺心病组(32例),同时选择健康男性志愿者作为对照组(40人)。采用超声心动图测量研究对象的肺动脉主干内径(MPA)、右室流出道内径(RVOT)、右室内径(RV)、三尖瓣返流峰值速度和右室流出道血流速度时间积分,估算右心房压力,计算肺动脉收缩压(PASP)、肺血管阻力(PVR)和肺动脉血流加速时间与右室射血时间(PAAT/RVET)比值。结果尘肺病合并肺心病组患者MPA、RVOT、RV分别宽于对照组和单纯尘肺病组(P<0.05),单纯尘肺病组患者RVOT宽于对照组(P<0.05)。尘肺病合并肺心病组患者PASP、PVR分别高于对照组和单纯尘肺病组(P<0.05),单纯尘肺病组患者PASP和PVR分别高于对照组(P<0.05)。尘肺病合并肺心病组和单纯尘肺病组患者PAAT/RVET比值分别低于对照组(P<0.05)。单纯尘肺病组患者MPA和RV分别与对照组比较,差异均无统计学意义(P>0.05)。结论应用超声心动图监测尘肺病患者肺循环血流动力学指标,可为临床制定早期干预措施提供依据。
Objective To investigate the changes and clinical value of pulmonary circulation hemodynamics detected by echocardiography in patients with pneumoconiosis. Methods A total of 102 patients with pneumoconiosis were enrolled in this study. The patients were divided into simple pneumoconiosis group (n = 70) and pneumoconiosis group (n = 70) according to whether the patients had chronic cor pulmonale (“pulmonary heart disease” Pulmonary heart disease group (32 cases), while healthy male volunteers as control group (40). Echocardiography was used to measure the time integral of MPA, RVOT, RV, peak velocity of tricuspid regurgitation and right ventricular outflow tract velocity Right atrial pressure, pulmonary artery systolic pressure (PASP), pulmonary vascular resistance (PVR) and pulmonary artery blood flow acceleration time and right ventricular ejection time (PAAT / RVET) ratio were calculated. Results The levels of MPA, RVOT and RV in patients with pneumoconiosis and pulmonary heart disease were significantly higher than those in controls and patients with pneumoconiosis alone (P <0.05). RVOT in patients with pneumoconiosis alone was more than that in controls (P <0.05). PASP and PVR in patients with pneumoconiosis and pulmonary heart disease were higher than those in control and pure pneumoconiosis patients (P <0.05). PASP and PVR in patients with pneumoconiosis alone were higher than those in controls (P <0.05). The PAAT / RVET ratio in patients with pneumoconiosis and pneumoconiosis was significantly lower than that in controls (P <0.05). MPA and RV in patients with simple pneumoconiosis group were no significant difference compared with the control group (P> 0.05). Conclusion The application of echocardiography to monitor pulmonary circulation hemodynamics in patients with pneumoconiosis can provide the basis for making early intervention in clinical practice.