摘要
目的探讨组织多普勒成像（tissue Doppler imaging，TDI）技术评价冠心病患者右心室功能的价值。方法120例行冠状动脉造影（CAG）者为研究对象，根据CAG、病史、症状、心电图、心肌酶等临床证据分为三组：对照组40例，冠状动脉狭窄〈50％；心绞痛组40例，至少一支主要冠状动脉狭窄≥70％；急性心肌梗死组40例。脉冲多普勒测量右室Tei指数（PW-Tei）；TDI分别测量三尖瓣环室间隔部和右室侧壁部Tei指数（TDI-Tei）及收缩期S波峰值速度（Sa）、舒张早期E波峰值速度（Ea）、舒张晚期A波峰值速度（Aa），计算Ea／Aa。结果①对照组、心绞痛组、心肌梗死组右室的PW-Tei和TDI-Tei逐渐升高，三组PW-Tei分别为0．363±0．086，0．463±0．078，0．569±0．066；三组TDI-Tei（三尖瓣环两部位均值）分别为0．400±0．058，0．520±0．078,0．628±0．059；三组间Ea和Ea／Aa逐渐减低；Sa在对照组和心绞痛组之间差异无统计学意义，心肌梗死组低于对照组和心绞痛组；②右室的PW-Tei与三尖瓣环室间隔部、侧壁部的TDI-Tei显著相关（r为0．596和0．776）；③三尖瓣环两个不同部位测量的TDI-Tei及速度指标均显著相关（r为0．628～0．767）。结论TDI技术可评价冠心病患者右室功能，TDI-Tei可敏感反映不同类型冠心病患者右室整体功能损害程度。
Objective To evaluate right ventricular（RV） function by tissue Doppler imaging（TDI） and Tei index in patients with coronary artery disease（CAD）. Methods One hundred twenty patients who underwent coronary angiography（CAG） were enrolled. Based on clinic evidences, such as CAG, disease history, symptom, ECG,and myocardial enzymes, all patients were divided into three groups：control group, angina group and myocardial infarction（MI） group. TDI was performed on the lateral and septal tricuspid annular. RV Tei index was obtained either from the pulse-wave Doppler（PW-Tei） and from TDI（TDI-Tei）. Results There were significant differences in RV PW-Tei, TDI-Tei, Ea, and Ea/Aa among three groups. PW-Tei was 0.363±0.086,0.463± 0.078 and 0.569±0.066,and TDI-Tei was 0.400±0.058,0.520±0.078 and 0.628±0.059 for the control group,angina group and MI group,respectively. Ea and Ea/Aa were gradually decreased following the severity of CAD. Sa was no difference between the control group and angina group,while Sa was much lower in myocardial infarction group than in other groups. RV PW-Tei had a good correlation with the lateral and septal TDI-Tei. The lateral and septal TDI-Tei were significant correlated with motion velocities. Conclusions TDI can be used to comprehensively evaluate RV function in patients with CAD. TDI-Tei can sensitive reflect the damage level of overall RV function in patients with different degree CAD.
出处
《中华超声影像学杂志》
CSCD
2008年第4期288-291,共4页
Chinese Journal of Ultrasonography
