心肌功能指数在慢性肺部疾病右心室功能测定中的价值.doc

心肌功能指数在慢性肺部疾病右心室功能测定中的价值 　　作者：庄瑞娟，金伟东，王晓彦 作者单位：江苏省无锡市第三人民医院心内科，江苏无锡214041 　　【摘要】 目的 探讨应用脉冲组织多普勒成像技术测量心肌功能指数(Tei指数)，对慢性肺心病患者右室功能进行定量评价。方法 对20例慢性肺心病患者和20例正常人进行经胸超声检查，采用心尖四腔心切面获取三尖瓣环心肌运动频谱图，分别测量收缩波(S)峰值速度(Sm)及S峰速度时间积分(Sm-VTI)、舒张早期峰值速度(et)及舒张晚期峰值速度(at)，并结合心电图标Ⅱ导联分别测量右室ICT、 IRT、ET，计算出Tei指数。结果 肺心病组右室Tei指数较正常组明显延长，肺心病组Sm、et及et/at均明显低于正常组(P0.05或P0.01)。肺心病组及正常组中Tei指数与年龄、心率无相关性，与Sm-VTI、et及et/at有相关性(P0.05或P0.01)。结论 Tei指数能准确、实时地反映右心功能，为定量评价慢性肺心病患者右室收缩和舒张功能提供了可靠的依据。 　　【关键词】 肺心病;心室功能，右;心肌功能指数 　　The value of Tei index in detecting right ventricular function of chronic pulmonary heart diseases 　　ZHUANG Rui-juan, JIN Wei-dong, WANG Xiao-yan 　　(Department of Cardiology, Wuxi No.3 Peoples Hospital, Wuxi, Jiangsu 214041, China) 　　Abstract: Objective To study the clinical value of Doppler tissue imaging (DTI) in detecting Tei index for quantitatively evaluating right ventricular function of chronic pulmonary heart diseases. Methods Twenty patients with chronic pulmonary heart diseases and twenty normal controls received pulse wave-DTI (PW-DTI) examination. The tricuspid annular motion was obtained by pulse-wave Doppler tissue imaging( PW-DTI). Systolic peak (S), systolic velocity (Sm) and its integral of velocity and time (Sm-VTI), as well as the peak velocity at early diastole (et) and at late diastole (at) were measured, respectively. ICT, ET,and IRT of right ventricle were obtained with ECG (LⅡ). Tei index was calculated. Results The Tei index of RV in chronic pulmonary heart disease was significantly higher than that of the control group. The Sm, Sm-VTI, et and et/at of the study group were significantly lower than that of the control group (P0.05 or P0.01), so the analysis showed there was no correlation between the Tei index with age and heart rate in both groups. However, Tei index correlated significantly with Sm-VTI, et and et/at (P0.05 or P0.01). Conclusion Tei index can exactly, real-time and quantitatively assess the dynamic changes of myocardiac mot