全方向M型超声心动图结合Tei指数评价先天性心脏病患者右心室功能

摘要

Objective To explore clinical application value of right ventricular function of patients with congenital heart diseases according to OME-Tei index of omni-directional M-mode echocardiography. Methods 60 patients with congenital heart diseases were allocated to the severe pulmonary hypertension group (>80mm Hg),the mild and moderate pulmonary hypertension group (40-80mm Hg) group and the no pulmonary hypertension group (<40mm Hg), with 11,23 and 26 in each respectively.Every patient was detected OME-Tei index of right ventricle by omni-directional M-mode echocardiography before operation,one week after the operation,three months after the operation and six months after the operation respectively and the OME-Tei index was compared and researched.ResultsFirstly,the OME-Tei index of right ventricle of the mild and moderate pulmonary hypertension group was increased compared with that of no pulmonary hypertension group before the operation. Secondly,the OME-Tei index was not obviously decreased in three periods after the operation in the no pulmonary hypertension group compared with that before the treatment.There was no significant difference.The OME-Tei indexes of the mild and moderate pulmonary hypertension group and the severe pulmonary hypertension group one week,three months and six months after the operation were all decreased compared with those before the operation.The differences have statistically significance.Thirdly, the OME-Tei index and pulmonary artery systolic pressure detected in every group have a good correlation.ConclusionTissue Doppler OME-Tei index can show changes of right ventricular function of patients with congenital heart diseases more sensitively.It is a better index combined with pulmonary artery systolic pressure used to the dynamic and long-term evaluation of right ventricular overall function.%目的探讨全方向M型超声心动图OME-Tei指数评价先天性心脏病患者右心室功能的临床应用价值。方法选取60例先天性心脏病患者，根据肺动脉压力升高情况分为三组：重度肺动脉高压组（＞80mm Hg）11例，轻中度肺动脉高压组（40～80mm Hg）23例和无肺动脉高压组（＜40mm Hg）26例，每位患者分别在手术前，手术后1周、3个月、6个月4个时期，应用全方向M型超声心动图测定右室OME-Tei指数进行对比研究。结果（1）手术前，与无肺动脉高压组相比较，轻中度肺动脉高压组右室OME-Tei指数升高，重度肺动脉高压组OME-Tei指数显著升高。（2）手术前后比较，无肺动脉高压组在术后3个时期的OME-Tei指数与术前相比降低不明显，无明显差异；轻中度肺动脉高压组与重度肺动脉高压组OME-Tei指数术后1周、3个月、6个月OME-Tei指数均较术前降低，其差异有统计学意义。（3）各组测得的OME-Tei指数与肺动脉收缩压呈良好的相关性。结论组织多普勒OME-Tei指数可较敏感的反映先天性心脏病患者的右心室功能变化，结合肺动脉收缩压，是可用于动态长期评价右心室整体功能的较好指标。