超声心动图评估肺动脉高压新方法.docVIP

超声心动图评估肺动脉高压新方法[摘要] 目的 评价超声心动图M型测得先天性房间隔缺损患者舒张期右室前壁厚度与舒张期左室后壁厚度比值（RVAW/LVPW）评估肺动脉高压的方法。方法 对入选98例单纯先天性房间隔缺损患者，用多普勒超声测得跨三尖瓣压差求得肺动脉收缩压，用M型超声测得舒张期右室前壁厚度与舒张期左室后壁厚度比值，比较两者相关性。结果 RVAW/LVPW比值与测跨三尖瓣压差求得肺动脉收缩压有良好相关性（P＜0.01）。结论 超声心动图RVAW/LVPW比值可以评估先天性房间隔缺损患者肺动脉高压的严重程度。 [关键词] 超声心动描记术；房间隔缺损；肺动脉高压 [中图分类号] R445.1 [文献标识码] B [文章编号] 1673-9701（2011）32-106-02 The Evaluation of Patients with Pulmonary Hypertension by a New Echocardiographic Method FENG Junling Department of Echocardiography of Yiwu Center Hospital，Yiwu 322000，China [Abstract] Objective To assess the valve of other quantitative echocardiographic criteria for pulmonary arterial hypertension（PAH）in patients with congenital atrial septa（the thickness ratio of the right ventricle end-diastolic anterior wall to the left ventricle edd-diastolic posterior wall，RVAW/LVPW）. Methods A total of 98 patients with isolated congenital atrial septal defect（ASD）were enrolled in this study，by M type ultrasound measure RVAW/LVPW，by doppler ultrasound measure tricuspid differential pressure. Bivariate correlations were evaluated using the chi-squared statistic. Results The RVAW/LVPW were correlated well with PASP measured by tricuspid valve differential pressure （P＜0.01）. Conclusion The RVAW/LVPW ratio can evaluate the severity of PAH in patients with ASD. [Key words] Echocardiography；Atrial spetal defect；Pulmonary arterial hypertension 肺动脉压是肺循环血流动力学的一项重要参数，是心脏病的临床诊断、手术指征、疗效评价、判断预后的重要依据。右心导管直接检测肺动脉压是金标准，但具有一定的创伤性、风险性且价格昂贵，更不便于随访复查，临床应用受到限制；而超声心动图估测肺动脉压具有无创性、易重复的优点[1，2]。本文通过多普勒超声检查三尖瓣反流测得肺动脉收缩压（pulmonary arterial systolic pressure，PASP）与M型超声测得舒张末期右室前壁厚度与舒张末期左室后壁厚度比值（the right ventricle end-diastolic anterior wall/the left ventricle edd-diastolic posterior wall，RVAW/LVPW）分别评估肺动脉高压（pulmonary arterial hypertension，PAH），研究两者的相关性。 1 资料与方法 1.1 一般资料 选择2009年6月～2010年10月在我科超声心动图诊断为房间隔缺损（Atrial septal defect，ASD）的患者98例，所有病例均伴有轻度以上三尖瓣反流，男45例，女53例。性别间差异无统计学意义（P＞0.05）。所有病例均为单纯先天性房间隔缺损，排除合并其他先天性心脏病及其他能够引起右心室壁增厚、肺动脉高压的疾病。根据三