右室Tei指数评价肺栓塞患者右心室功能

摘要

Objective To investigate the value of Tei index derived from Tissue Doppler Imaging (TDI) in evaluating right ventricular function of patients with pulmonary embolism(PE). Methods 28 patients with pulmonary embolism and 30 controls were studied and the patients were divided into 3 groups according to the expected PE-related early mortality. Some traditional ultrasonic parameters of right heart time parameters and TDI-derived Tei Index were measured and compared. TDI data were acquired from tricuspid annular on apical four-chamber view. Results Compared with the control group, the right ventricular ejection time (ET) of high-risk group of patients with pulmonary embolism was significantly shorter (P <0. 05), Their isovolumic contraction (ICT) isovolumetric relaxation time (IRT) and Tei index were all significantly increased (P<0. 05) , They had characteristic echocardiographic appearance of right ventricular dilation and pulmonary hypertension. However, the Tei index of moderate-risk group also appeared significant difference (P<0. 05), but had no dilated right ventricular. There was no significant difference in low-risk group(P>0. 05). Conclusions Tei index measured by TDI acquired from tricuspid annular is a sensitive indicator of right ventricular global function.%目的 探讨应用组织多普勒成像技术(tissue Doppler imaging,TDID测算右室Tei指数评价肺栓塞患者右心室功能的临床应用价值.方法 人选研究对象为正常对照组和肺栓塞组,并根据预期的肺栓塞相关早期病死率进行危险分层为高危、中危、低危3个组,测量其右心常规超声指标,运用TDI获取三尖瓣环组织运动频谱,测量相关时间间期,并计算出右心室Tei指数.结果 与对照组相比,肺栓塞患者高危组具有较明显的右心扩大及肺动脉高压征象,其右室射血时间(ET)明显缩短(P＜0.05),等容收缩期(ICT)+等容舒张期(IRT)明显延长(P＜0.05),Tei指数明显增高(P＜0.05)；中危组尽管没有明显右心增大,但其右室ET、ICT+ IRT、Tei指数均已出现异常(P＜0.05)；低危组的ET、ICT+ IRT、Tei指数与对照组相比,差异无统计学意义(P＞0.05).结论 运用TDI测量右室Tei指数可以较敏感反映肺栓塞患者右室功能变化,是评价其右室综合功能的较好指标.