肝中靜脈血流頻譜變化對(duì)肺動(dòng)脈高壓診斷的臨床評(píng)價(jià)
本文選題:肺動(dòng)脈高壓 + 肝中靜脈; 參考:《中國(guó)超聲醫(yī)學(xué)雜志》2015年04期
【摘要】:目的分析肺動(dòng)脈高壓患者肝中靜脈血流多普勒頻譜的變化規(guī)律,篩選適合臨床使用的診斷肺動(dòng)脈高壓的新指標(biāo)。方法收集預(yù)行封堵術(shù)的先天性心臟病患者80例,經(jīng)右心導(dǎo)管測(cè)量其肺動(dòng)脈壓力,經(jīng)超聲測(cè)量肝中靜脈頻譜各波的峰值速度(V)和速度時(shí)間積分(VTI),評(píng)價(jià)其對(duì)肺動(dòng)脈高壓的預(yù)測(cè)價(jià)值,確定截?cái)帱c(diǎn)。結(jié)果與對(duì)照組相比,肺動(dòng)脈高壓組SV、SVTI、DV、DVTI降低,ARV、ARVTI、ARV/SV、ARVTI/SVTI、ARV/(SV+DV)、ARVTI/(SVTI+DVTI)升高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。相關(guān)分析顯示ARV/SV、ARV/(SV+DV)、ARVTI/(SVTI+DVTI)比值與肺動(dòng)脈平均壓具有相關(guān)性(r=0.529、0.575、0.438,P均0.001)。ROC曲線分析結(jié)果顯示ARV/(SV+DV)比值對(duì)于肺動(dòng)脈高壓的診斷效果優(yōu)于其他參數(shù),ARV/(SV+DV)比值=0.30時(shí),對(duì)肺動(dòng)脈高壓診斷的靈敏度85.37%、特異度75.00%。結(jié)論以肝中靜脈ARV/(SV+DV)比值=0.30為界值,診斷肺動(dòng)脈高壓具有較好的靈敏度及特異度,可以作為超聲心動(dòng)圖評(píng)價(jià)肺動(dòng)脈高壓指標(biāo)的有力補(bǔ)充。
[Abstract]:Objective to analyze the changes of Doppler spectrum of intrahepatic venous blood flow in patients with pulmonary hypertension and to screen new indexes for diagnosis of pulmonary hypertension.Methods the pulmonary artery pressure was measured by right cardiac catheterization in 80 patients with congenital heart disease. The peak velocities of each wave of middle hepatic vein (VV) and velocity-time integral (VTI) were measured by ultrasound to evaluate its predictive value for pulmonary hypertension.Determine the cut-off point.Results compared with the control group, SVVTI DVTI decreased ARV / ARVTI / SVVTI / SVVTI / SVVTI / SVTI DVTI in pulmonary hypertension group, and the difference was statistically significant (P 0.05).Correlation analysis showed that there was a correlation between ARV / SVV / V V / V V / V V / V V / V V / V ratio and mean pulmonary artery pressure. The results of 0.001).ROC curve analysis showed that the ratio of ARV/(SV DVT was better than that of other parameters in the diagnosis of pulmonary hypertension (P < 0. 30).The sensitivity of diagnosis of pulmonary hypertension was 85.37 and the specificity was 75.00.Conclusion taking the ratio of ARV/(SV DVV of middle hepatic vein as the threshold value, the diagnosis of pulmonary hypertension has good sensitivity and specificity. It can be used as an effective complement to echocardiography in the evaluation of pulmonary hypertension.
【作者單位】: 吉林醫(yī)藥學(xué)院口腔影像系;第四軍醫(yī)大學(xué)唐都醫(yī)院超聲科;沈陽(yáng)軍區(qū)總醫(yī)院先心病內(nèi)科;第四軍醫(yī)大學(xué)唐都醫(yī)院心內(nèi)科;吉林醫(yī)藥學(xué)院附屬醫(yī)院特診科;
【基金】:吉林省科技發(fā)展計(jì)劃項(xiàng)目(No.20130522016JH) 吉林市科技計(jì)劃項(xiàng)目(No.201464046)
【分類號(hào)】:R544.1;R445.1
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