【摘要】：目的：探討心臟MRI評估肺動脈高壓患者左、右心室功能的臨床應用價值。 材料與方法：對30例肺動脈高壓患者及30例健康志愿者(對照組)進行心臟MRI檢查,分別計算兩組左、右心功能及左、右室心肌質(zhì)量,心室質(zhì)量指數(shù)(VMI)為舒張末期RV MM與LV MM的比值。肺動脈高壓組根據(jù)病情進展分為慢性阻塞性肺病組和肺心病組。兩組比較采用t檢驗,多組比較采用單因素方差分析,兩兩比較采用LSD-t檢驗。 結(jié)果：5例肺動脈高壓患者MRI檢查時由于屏氣時間長、不能配合而排除,與對照組比較,PH組患者RV EDV、ESV、MM均顯著高于對照組(P0.05), RV EF、SV顯著低于對照組(P0.05)。PH組患者LV EDV、SV、EF、PER、PFR顯著低于對照組(P0.05),而LV ESV、MM與對照組的差異均無統(tǒng)計學意義(P0.05)。PH組VMI顯著高于對照組(P0.05)。與對照組比較COPD組、CP組患者RV EDV、ESV、MM均顯著高于對照組(P0.05), RV EF、SV顯著低于對照組(P0.05)。與對照組比較,COPD組患者LV SV、PFR顯著低于對照組(P0.05),而LV EDV、ESV、EF、PER和MM與對照組的差異均無統(tǒng)計學意義(P0.05)。與對照組比較,CP組患者LV EDV、SV、EF、PER和PFR顯著低于對照組(P0.05),而LV ESV和MM與對照組的差異均無統(tǒng)計學意義(P0.05)。 結(jié)論：肺動脈高壓導致右心室擴大,右心功能下降,同時左心功能受損,且左心舒張功能受損早于收縮功能受損。心臟MRI能夠無創(chuàng)、準確的提供PH患者RV與LV的功能信息,對于評價PH患者心室功能具有重要價值。
[Abstract]:Objective: to evaluate the clinical value of cardiac MRI in assessing left and right ventricular function in patients with pulmonary hypertension. Materials and methods: heart MRI was performed in 30 patients with pulmonary hypertension and 30 healthy volunteers (control group). The left and right cardiac function and the myocardial mass of left and right ventricle were calculated respectively in the two groups. The ventricular mass index (VMI) was the ratio of end-diastolic RV MM to LV MM. Pulmonary hypertension group was divided into chronic obstructive pulmonary disease group and cor pulmonale group. T test was used in two groups, single factor analysis of variance and LSD-t test were used in multiple groups. Results: in 5 patients with pulmonary hypertension, the RV EDV,ESV,MM in PH group was significantly higher than that in control group (P0.05), RV EF,) because of the long breath holding time and could not be combined with RV EDV,ESV,MM examination in 5 patients with pulmonary hypertension. SV was significantly lower than that in control group (P0.05) LV EDV,SV,EF,PER,PFR in). PH group was significantly lower than that in control group (P0.05), while LV ESV, was significantly lower in). PH group. There was no significant difference between MM and control group (P0.05 VMI in). PH group was significantly higher than that in control group (P0.05). Compared with control group, RV EDV,ESV,MM in CP group was significantly higher than that in control group (P0.05), RV EF,SV was significantly lower than that in control group (P0.05). Compared with the control group, the LV SV,PFR of COPD group was significantly lower than that of the control group (P0.05), while the LV EDV,ESV,EF,PER and MM had no significant difference with the control group (P0.05). Compared with control group, LV EDV,SV,EF,PER and PFR in CP group were significantly lower than those in control group (P0.05), while LV ESV and MM had no statistical significance (P0.05). Conclusion: pulmonary hypertension leads to right ventricular dilatation, decreased right ventricular function, and impaired left ventricular function, and the left ventricular diastolic function is impaired earlier than that of systolic function. Cardiac MRI can provide noninvasive and accurate information about RV and LV in patients with PH. It has important value in evaluating ventricular function in PH patients.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R445.2;R544.1

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