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目的:评价不同超声心动图指标和组合方式在右心衰竭中的诊断价值。方法:右心衰竭组患者62例,对照组健康成人52例,应用超声诊断仪测量三尖瓣环收缩位移(TAPSE)、收缩期峰值速度(Sm)、游离壁基底段应变(BS)、中间段应变(MS)、右心室舒张末期面积(RVEDA)和收缩末期面积(RVESA),计算右心室面积变化率。用逐步判别法分析结果,建立诊断右心衰竭的判别模型。分别用TAPSE<15mm、Sm<11.5cm/s及二者串联和并联试验4种方法诊断右心衰竭。结果:与对照组比较,右心衰竭组RVEDA和RVESA增加,TAPSE、Sm、BS和MS显著降低(均P<0.01)。诊断右心衰竭的判别模型:右心衰竭F=1.166×TAPSE+1.732×Sm-14.134,非右心衰竭F=1.779×TAPSE+2.627×Sm-31.818;两者串联时诊断灵敏度为90.3%,特异度为88.5%,正确率为89.5%。结论:诊断右心衰竭时,TAPSE与Sm更具价值,两者串联临床意义更大。
Objective: To evaluate the diagnostic value of different echocardiographic parameters and combinations in right heart failure. Methods: 62 patients with right heart failure and 52 healthy controls were enrolled in this study. TAPSE, Sm, BS, Segmental strain (MS), right ventricular end-diastolic area (RVEDA) and end-systolic area (RVESA) were calculated to calculate the rate of right ventricular area change. Stepwise discriminant analysis of the results to establish the diagnosis of right heart failure discriminant model. Right heart failure was diagnosed by TAPSE <15mm, Sm <11.5cm / s and the two methods of series and parallel experiments. Results: Compared with the control group, RVEDA and RVESA increased, while TAPSE, Sm, BS and MS decreased significantly in right heart failure group (all P <0.01). Right ventricular failure diagnosis of right heart failure model F = 1.166 × TAPSE + 1.732 × Sm-14.134, non-right heart failure F = 1.779 × TAPSE + 2.627 × Sm-31.818; the diagnostic sensitivity of the two series was 90.3%, specificity Degree was 88.5%, the correct rate was 89.5%. Conclusion: When diagnosing right heart failure, TAPSE is more valuable than Sm, and the tandem clinical significance is greater.