心脏超声技术对肺动脉高压患者右心功能的诊断价值

doi:10.3760/cma.j.cn441417-20250306-13012

国际医药卫生导报 ›› 2025, Vol. 31 ›› Issue (13): 2171-2175.DOI: 10.3760/cma.j.cn441417-20250306-13012

心脏超声技术对肺动脉高压患者右心功能的诊断价值

段佳庆¹ 陈红亮¹ 续庆艳¹ 杨辉¹ 谢新明²

¹兵器工业总医院超声诊断科，西安 710065；²西安交通大学第一附属医院病理科，西安 710061

收稿日期:2025-03-06 出版日期:2025-07-01 发布日期:2025-08-04
通讯作者: 陈红亮，Email：chlxiaobudian@163.com
基金资助:
国家自然科学基金（81800052）；2021年度管理创新及新技术项目（202112231620000508401）

The diagnostic value of cardiac ultrasound technology for right heart function in patients with pulmonary arterial hypertension

Duan Jiaqing¹, Chen Hongliang¹, Xu Qingyan¹, Yang Hui¹, Xie Xinming²

¹Department of Ultrasound Diagnosis, Norinco General Hospital, Xi'an 710065, China; ²Department of Pathology, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an 710061, China

Received:2025-03-06 Online:2025-07-01 Published:2025-08-04
Contact: Chen Hongliang, Email:chlxiaobudian@163.com
Supported by:
National Natural Science Foundation of China (81800052); 2021 Annual Management Innovation and New Technology Project (202112231620000508401)

摘要/Abstract

摘要：

目的　探讨心脏超声技术对肺动脉高压（PAH）患者右心功能的诊断价值。方法　选取2023年11月至2024年10月兵器工业总医院收治的65例PAH患者作为研究组，男31例，女34例；年龄（63.83±7.87）岁。根据肺动脉收缩压（sPAP）水平，将研究组分成3级，轻度22例［35～≤50 mmHg（1 mmHg=0.133 kPa）］；中度22例（50～≤70 mmHg）；重度21例（>70 mmHg）。选取同期的65例健康体检者作为对照组，男38例，女27例；年龄（62.34±7.96）岁。比较两组心脏超声指标［右心室收缩末期容积（ESV）、舒张末期容积（EDV）、A峰与E峰流速比值（A/E）、每搏输出量（SV）、射血分数（EF）］、肺动脉压指标［sPAP、肺动脉舒张压（dPAP）、平均肺动脉压（mPAP）］；比较轻、中、重度PAH患者心脏超声指标（ESV、EDV、A/E、SV、EF）和肺动脉压指标（dPAP、mPAP）。采用独立样本t检验、方差分析、配对t检验和χ²检验进行统计学分析。采用受试者操作特征曲线（ROC）分析心脏超声指标、肺动脉压指标对PAH患者右心功能的诊断效能。结果　研究组ESV、EDV、A/E、SV、EF均低于对照组［（31.58±5.52）ml比（41.81±6.34）ml、（65.39±6.86）ml比（80.37±7.31）ml、0.83±0.14比1.62±0.11、（56.95±6.87）ml比（71.42±6.58）ml、（32.69±5.73）%比（45.33±5.82）%］（均P<0.05）。研究组sPAP、dPAP、mPAP均高于对照组［（56.43±5.65）mmHg比（24.47±3.07）mmHg、（40.75±4.51）mmHg比（23.84±3.60）mmHg、（48.83±6.94）mmHg比（16.04±3.56）mmHg］（均P<0.05）。重度PAH患者ESV、EDV、A/E、SV、EF均低于轻、中度PAH患者（均P<0.05）；中度PAH患者ESV、EDV、A/E、SV、EF均低于轻度PAH患者（均P<0.05）。重度PAH患者dPAP、mPAP均高于轻、中度PAH患者（均P<0.05）；中度PAH患者dPAP、mPAP均高于轻度PAH患者（均P<0.05）。心脏超声指标联合肺动脉压指标诊断PAH患者右心功能的曲线下面积（AUC）、灵敏度、特异度均高于单独诊断（均P<0.05）。结论　心脏超声技术应用于PAH患者右心功能诊断，可提高诊断效能，临床应用价值较高。

关键词: 心脏超声技术, 肺动脉高压, 右心功能

Abstract:

Objective　To explore the diagnostic value of cardiac ultrasound technology for right heart function in patients with pulmonary arterial hypertension (PAH). Methods　Sixty-five patients with PAH who were admitted to Norinco General Hospital from November 2023 to October 2024 were selected as the study group. There were 31 males and 34 females in the study group, aged (63.83±7.87) years. The study group was divided into three levels based on the pulmonary artery systolic pressure (sPAP) level: 22 cases were classified as mild [35-≤50 mmHg (1 mmHg=0.133 kPa)]; 22 cases as moderate (50-≤70 mmHg); and 21 cases as severe (>70 mmHg). Sixty-five healthy individuals who underwent physical examinations at the same time were selected as the control group. There were 38 males and 27 females in the control group, aged (62.34±7.96) years. The cardiac ultrasound indicators [right ventricular end-systolic volume (ESV), end-diastolic volume (EDV), ratio of peak A velocity to peak E velocity (A/E), stroke volume (SV), ejection fraction (EF)] and pulmonary artery pressure indicators [sPAP, pulmonary artery diastolic pressure (dPAP), mean pulmonary artery pressure (mPAP)] were compared between two groups. The cardiac ultrasound indicators (ESV, EDV, A/E, SV, EF) and pulmonary artery pressure indicators (dPAP, mPAP) were compared among patients with mild, moderate, and severe PAH. Independent sample t test, analysis of variance, paired t test, and χ² test were used for statistical analysis. The diagnostic efficacy of cardiac ultrasound indicators and pulmonary artery pressure indicators for right heart function in patients with PAH was analyzed using the receiver operating characteristic curve (ROC). Results　The ESV, EDV, A/E, SV and EF values of the study group were all lower than those of the control group [(31.58±5.52) ml vs. (41.81±6.34) ml, (65.39±6.86) ml vs. (80.37±7.31) ml, 0.83±0.14 vs. 1.62±0.11, (56.95±6.87) ml vs. (71.42±6.58) ml, (32.69±5.73)% vs. (45.33±5.82)%] (all P<0.05). The sPAP, dPAP and mPAP values of the study group were all higher than those of the control group [(56.43±5.65) mmHg vs. (24.47±3.07) mmHg, (40.75±4.51) mmHg vs. (23.84±3.60) mmHg, (48.83±6.94) mmHg vs. (16.04±3.56) mmHg] (all P<0.05). The ESV, EDV, A/E, SV and EF values of patients with severe PAH were all lower than those of patients with mild and moderate PAH (all P<0.05); the ESV, EDV, A/E, SV and EF values of patients with moderate PAH were all lower than those of patients with mild PAH (all P<0.05). The dPAP and mPAP values of patients with severe PAH were higher than those of patients with mild and moderate PAH (all P<0.05); the dPAP and mPAP values of patients with moderate PAH were also higher than those of patients with mild PAH (both P<0.05). The area under the curve (AUC), sensitivity and specificity of the combined use of cardiac ultrasound indicators and pulmonary artery pressure indicators in diagnosing right heart function in patients with PAH were all higher than those of single diagnosis (all P<0.05). Conclusion　Cardiac ultrasound technology is applied to the diagnosis of right heart function in patients with PAH, which can enhance the diagnostic efficiency and has a relatively high clinical application value.

Key words: Cardiac ultrasound technology, , Pulmonary arterial hypertension, , Right heart function

段佳庆陈红亮续庆艳杨辉谢新明.

心脏超声技术对肺动脉高压患者右心功能的诊断价值 [J]. 国际医药卫生导报, 2025, 31(13): 2171-2175.

Duan Jiaqing, Chen Hongliang, Xu Qingyan, Yang Hui, Xie Xinming.

The diagnostic value of cardiac ultrasound technology for right heart function in patients with pulmonary arterial hypertension [J]. International Medicine and Health Guidance News, 2025, 31(13): 2171-2175.

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心脏超声技术对肺动脉高压患者右心功能的诊断价值

The diagnostic value of cardiac ultrasound technology for right heart function in patients with pulmonary arterial hypertension

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