【摘要】：肺動脈高壓的主要特點是肺血管阻力進行性升高,肺血管重構(gòu),導(dǎo)致患者最}B因右心衰竭而死。右房在此過程中發(fā)生結(jié)構(gòu)與功能的改變,這對調(diào)節(jié)右室充盈和維持整體心輸出量具有舉足輕重的作用,為肺動脈高壓患者監(jiān)測病情和判斷預(yù)后提供重要線索。1與左心房相似,在心臟整個心動周期中,右房亦具有三個基本功能:(1)儲器功能:在三尖瓣關(guān)閉時,右房儲存經(jīng)上、下腔靜脈和冠狀靜脈竇回流的血液;(2)管道功能:在三尖瓣開放早期,系統(tǒng)靜脈血借助右室的主動抽吸作用于右房被動的進入右室;(3)助力泵功能:在三尖瓣開放后期,右房主動收縮泵血進一步增加右室充盈。2肺動脈高壓時,長期的后負(fù)荷增加導(dǎo)致右室發(fā)生心肌重構(gòu),順應(yīng)性減低,心腔擴大,容積增加,最終出現(xiàn)舒縮功能障礙。與此同時右房發(fā)生一系列結(jié)構(gòu)和功能的改變,如右房擴大,壓力增加,右房三個時相的功能發(fā)生代償性改變等。由于右房形態(tài)的復(fù)雜性及研究方法學(xué)的限制,國內(nèi)外目前針對右房的研究相對較少,現(xiàn)就肺動脈高壓患者右房結(jié)構(gòu)和功能的評估做一些綜述。
[Abstract]:Pulmonary hypertension is characterized by progressive increase in pulmonary vascular resistance, pulmonary vascular remodeling, leading to the death of patients with right heart failure. Changes in structure and function of right atrium occur during this process, which plays an important role in regulating right ventricular filling and maintaining global cardiac output, and provides important clues for monitoring the condition and judging prognosis in patients with pulmonary hypertension, which is similar to that of left atrium. Throughout the cardiac cycle, the right atrium also has three basic functions: (1) storage function: when the tricuspid valve is closed, the right atrium stores the blood flowing through the superior, inferior vena cava and coronary sinus; (2) the conduit function: at the early stage of tricuspid valve opening, (3) the function of booster pump: at the late stage of tricuspid valve opening, the right atrial active contraction pump further increased the right ventricular filling of pulmonary hypertension. Long term afterload increase leads to right ventricular remodeling, decreased compliance, enlarged heart cavity, increased volume, and eventually resulted in systolic and diastolic dysfunction. At the same time, a series of structural and functional changes occurred in the right atrium, such as the enlargement of the right atrium, the increase of pressure, and the compensatory changes of the function of the three phases of the right atrium. Due to the complexity of right atrium morphology and the limitation of research methodology, there are relatively few studies on right atrium at home and abroad. This paper reviews the evaluation of right atrial structure and function in patients with pulmonary hypertension.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R544.1

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