Abstract
目的 探讨利用超声检测技术评价尘肺并发肺心病患者右室壁心肌的收缩功能及其诊断价值.方法 选择尘肺并发肺心病患者50例,选择单纯尘肺患者50例,测定右室前壁、下壁及侧壁的基底段、中段、心尖段的心内膜下心肌层的组织速度和应变率曲线,分别测量每一曲线上的收缩期平均峰值速度、达-峰值速度时间、收缩期峰值位移、收缩期峰值应变和收缩期峰值应变率；对于与尘肺组相比差别有显著性的参数通过受试工作特征曲线确定其诊断界值；将右室壁各节段各收缩期参数与右心房射血分数进行直线相关性分析.结果 尘肺并发肺心病组右室壁所有节段的PSs均小于尘肺组,差异有统计学意义(P＜0.05)；尘肺并发肺心病组前、下、侧壁的基底段及前壁的中段PDs均小于尘肺组,差异有统计学意义(P＜0.05)；尘肺并发肺心病组前壁基底段、中段及下壁中段PSRs小于尘肺组,差异有统计学意义(P＜0.05)；尘肺并发肺心病组TTP在侧壁心尖段与尘肺组的差异有统计学意义(P＜0.05),尘肺并发肺心病组右室壁的所有节段的PSs,右室前壁基底段及侧壁中段的PSRs,下壁及前壁的基底段PDs与RVEF呈正直线相关,r为0.20～0.85(P＜0.05)；而右室壁的所有节段的APVs,TTP与RVEF无直线相关性(P＞0.05).结论 超声技术能够评价尘肺并发肺心病右室壁的心肌收缩功能；右室前壁是超声分析的最重要室壁,右室各壁的基底段是超声检测时着重注意的节段。
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