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目的 通过拟合肺动脉高压(PAH)患者压力-容积环并计算相关参数,研究右心室-肺动脉耦合的相关机制.方法 纳入2015年1月至2015年12月在武汉亚洲心脏病医院住院的34例PAH患者以及5例卵圆孔未闭拟行经皮导管介入封堵术患者,根据肺动脉平均压分为三组:对照组(5例),肺动脉平均压<25 mmHg(即卵圆孔未闭患者,1 mmHg=0.133 kPa);A组(9例),25 mmHg≤肺动脉平均压<50 mmHg;B组(25例),肺动脉平均压≥50 mmHg.PAH入组标准遵照最新的欧洲PA H指南,所有入组患者实施侵入性导管压力检查及磁共振成像(M R I)检查,通过GetData软件将压力进行数字化处理,CMRtools 3D导出右心室-容积的数据,拟合压力-容积环并计算最大压力(Pmax)、收缩末期弹性(Ees)、动脉弹性(Ea)等相关参数.比较三组患者压力-容积环并计算相关参数.结果 B组患者右心室Pmax显著高于对照组[(207.88±65.67)mmHg比(53.05±12.87)mmHg,P<0.05]、A组[(207.88±65.67)mmHg比(134.73±26.38)mmHg,P<0.05],A组显著高于对照组[(134.73±26.38)mmHg比(53.05±12.87)mmHg,P0.05]有上升趋势,但差异无统计学意义,而B组Ees显著高于对照组[(1.53±0.97)比(0.60±0.28),P<0.05],差异有统计学意义.B组Ea显著高于对照组[(1.34±0.74)比(0.39±0.15),P<0.05],而Ees/Ea显著低于对照组[(1.12±0.47)比(1.62±0.51),P0.05). The Ees of group B was significantly higher than the control group[(1.53±0.97)vs.(0.60±0.28),P<0.05]. The Ea of group B was higher than the control[(1.34±0.74) vs.(0.39±0.15),P<0.05]. The overall ratio of Ees/Ea was lower in group B as compared to the control group [(1.12±0.47)vs.(1.62±0.51),P<0.05].Conclusions In the early stage of pulmonary hypertension, right ventricular contractility preserves and can overcome the slightly elevated afterload .The right ventricle and pulmonary artery coupled with good work. With the increasing mean pulmonary artery,the afterload of right ventricular increases and right ventricular contractility needs further increase to fight against the elevated afterload. The elevation of contractility cannot overcome the change of afterload, resulting in the off paired of mechanical efflciency, causing the right ventricle- pulmonary artery coupling decreases.