2018 年第 6 期 第 13 卷

超声多普勒Tei指数在评估慢性阻塞性肺疾病患者右心室功能中的价值

Evaluation of right ventricular function in patients with chronic obstructive pulmonary disease using ultrasonic Doppler Tei index

作者：肖瑶李松南杨娅刘国文张向峰高杨朱光发

英文作者：

单位：100029首都医科大学附属北京安贞医院呼吸与危重症医学科（肖瑶、张向峰、高杨、朱光发），心内科（李松南），超声科（杨娅、刘国文）

英文单位：

关键词：慢性阻塞性肺疾病；超声心动图；Tei指数；右心室功能

英文关键词：

• 摘要：

• 【摘要】目的    探讨Tei指数在评估慢性阻塞性肺疾病（COPD）患者右心室功能中的价值。方法    选取2016年4月至2017年4月首都医科大学附属北京安贞医院呼吸与危重症医学科临床诊断的稳定期COPD患者44例作为COPD组，完成动脉血气分析［动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)］、经胸超声心动图检查、肺功能［第1秒用力呼气容积(FEV1)、用力肺活量(FVC)］测定以及6 min步行距离(6MWD)试验。选择同期健康志愿者12名为对照组，行经胸超声心动图检查。计算Tei指数。比较各组间肺功能、超声心动图参数、Tei指数，并分析各临床参数与Tei指数的相关性。结果    COPD组Tei指数明显高于对照组［(0.52±0.10)比（0.43±0.04）］，差异有统计学意义(P<0.01)。COPD合并肺动脉高压（PH）组与COPD未合并PH组Tei指数均明显高于对照组［(0.54±0.13）、（0.51±0.08）比（0.43±0.04）］，差异均有统计学意义(均P<0.05)；但COPD合并PH组与COPD未合并PH组间各指标差异无统计学意义（P>0.05）。肺功能重度极重度减退组Tei指数明显高于对照组［(0.52±0.10）比（0.43±0.04）］，差异有统计学意义(P<0.05)；肺功能轻中度减退组与对照组Tei指数差异无统计学意义(P>0.05)。稳定期COPD患者Tei指数与PaO2、PaCO2水平、FEV1、FVC值以及6MWD均无相关关系(均P＞0.05)。结论    Tei指数能较敏感、准确地评价COPD患者的右心室功能。

• 【Abstract】Objective    To investigate the value of Tei index in evaluation of right ventricular function in patients with chronic obstructive pulmonary disease(COPD). Methods    Forty-four patients with COPD in stationary phase（COPD group） were enrolled from April 2016 to April 2017 in Beijing Anzhen Hospital, Capital Medical University to have arterial blood gas test［arterial partial pressure of oxygen(PaO2), arterial partial pressure of carbon dioxide(PaCO2)］, transthoracic echocardiography, lung function test［forced expiratory volume in one second(FEV1), forced vital capacity(FVC)］ and 6 min walking distance(6MWD) test; 12 healthy volunteers（control group） were enrolled to have transthoracic echocardiography; Tei index was calculated by transthoracic echocardiographic results. Relations among lung function indexes, echocardiographic parameters and Tei index were analyzed. Results    Tei index in COPD group was significantly higher than that in control group［(0.52±0.10) vs （0.43±0.04）］(P<0.01). Tei index in COPD complicated with pulmonary hypertension（PH） group and COPD without PH group was significantly higher than that in control group［(0.54±0.13）,（0.51±0.08） vs （0.43±0.04）］(P<0.05); there was no statistical difference of Tei index between COPD with PH group and COPD without PH group(P>0.05). Tei index in severe pulmonary dysfunction group was significantly higher than that in control group［(0.52±0.10） vs （0.43±0.04）］(P<0.05); there was no significant difference of Tei index between mild-to-moderate pulmonary dysfunction group and control group(P>0.05). There was no correlation of Tei index with PaO2, PaCO2, FEV1, FVC and 6MWD(P>0.05). Conclusion    Tei index is sensitive and accurate in evaluating right ventricular function of patients with COPD.