核素心血池显像评价肺动脉高压患者右心室不同步性的研究

doi:10.12117/jccmi.2019.01.002

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摘要目的：探讨核素心血池显像评价肺动脉高压患者右心室不同步性的价值。方法：入选35例肺动脉高压（PH）患者和20例健康人为对照组。使用ERNA的相位分析软件，计算不同步参数右心室相角程（RVmPA），右心室峰相位标准差（RVPSD）和右心室射血分数（RVEF）。同时测量6分钟步行距离（6-MWD）和N末端B型利钠肽原（NT-proBNP）来评价PH患者的右心室功能。结果：PH组患者的RVEF，RVmPA和RVPSD分别为（36.57±7.43%，（403.91±81.78）ms和（54.46±15.05）ms）。与对照组（48.55±7.22，（251.61±68.44）ms和（36.09±11.55）ms）相比，RVEF 明显减低（P<0.001），右心室不同步参数RVmPA和RVPSD也明显增大（P<0.001）。不同步参数RVmPA和RVPSD与RVEF，6-MWD和NT-proBNP有显著相关性（RVmPA：R=0.725，0.645，0.633，P<0.001；RVPSD：R=0.804，0.733，0.725，P<0.001）。结论：ERNA的相位分析技术可以评价PH患者的右心室不同步性。ERNA的右心室不同步参数与右心功能有显著相关性。

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	陈雨
	谷阳
	林振宇
	徐海燕
	严山
	马树人
	张喜文

关键词 ：高血压, 肺性；心室功能, 右；门控血池显像

Abstract：Objective: The purpose of this study was to evaluate the right ventricular(RV) dyssynchrony in pulmonary hypertension(PH) patients using equilibrium radionuclide angiography(ERNA). Methods: Thirty-five PH patients and twenty healthy controls were included. ERNA was performed to calculate both RV ejection fraction(RVEF) and dyssynchrony parameters including RV phase shift(RVmPA) and RV phase standard deviation(RVPSD). The 6-minute walking distance(6-MWD) and N-terminal pronatriuretic peptide(NT-proBNP) were also detected to evaluate RV function of PH patients. Results: The mean RVEF, RVmPA and RVPSD of the PH group were 36.57±7.43%, (403.91±81.78)ms, and (54.46±15.05)ms, respectively. Compared with the control group, RVEF was significantly decreased(P<0.001), while RVmPA and RVPSD were significantly increased(P<0.001). RVmPA and RVPSD were significantly correlated with RVEF, 6-MWD and NT-proBNP(RVmPA: r=0.725, 0.645, 0.633, P<0.001; RVPSD: r=0.804, 0.733, 0.725, P<0.001). Conclusion: ERNA is feasible to evaluate RV mechanical dyssynchrony in PH patients. RV dyssynchrony parameters measured by phase analysis of ERNA were significantly correlated with RV function.

Key words： Hypertension, pulmonary Ventricular function, right Gated blood-pool imaging

收稿日期: 2018-01-24

PACS:	R541.3
	Ｒ817.4

通讯作者: 张喜文，南京医科大学附属淮安市第一人民医院心内科，223300。E-mail：2276041794@qq.com

作者简介: 陈雨（1982-），男，江苏泗阳人，主治医师，讲师。E-mail：63611592@qq.com

引用本文:

陈雨，谷阳，林振宇，徐海燕，严山，马树人，张喜文. 核素心血池显像评价肺动脉高压患者右心室不同步性的研究[J]. 中国临床医学影像杂志, 2019, 30(1): 4-7.
CHEN Yu, GU Yang, LIN Zhen-yu, XU Hai-yan, YAN Shan, MA Shu-ren, ZHANG Xi-wen. Assessment of right ventricular dyssynchrony in patients with pulmonary hypertension using equilibrium radionuclide angiography. JOURNAL OF CHINA MEDICAL IMAGING, 2019, 30(1): 4-7.

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http://www.jccmi.com.cn/CN/10.12117/jccmi.2019.01.002 或 http://www.jccmi.com.cn/CN/Y2019/V30/I1/4

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