应用超声心动图评估肝硬化患者心脏结构和功能临床价值研究*

doi:10.3969/j.issn.1672-5069.2020.02.026

实用肝脏病杂志 ›› 2020, Vol. 23 ›› Issue (2): 252-255.doi: 10.3969/j.issn.1672-5069.2020.02.026

应用超声心动图评估肝硬化患者心脏结构和功能临床价值研究^*

胡星, 孟繁坤, 韩晶, 张旭辉

100069 北京市首都医科大学附属北京佑安医院超声与功能诊断中心

收稿日期:2019-05-30 出版日期:2020-03-10 发布日期:2020-04-20
通讯作者: 孟繁坤,E-mail: mengfankun818@126.com
作者简介:胡星,女,35 岁,硕士研究生。主要从事腹部、心脏和小器官超声诊断研究。E-mail: diandianer@126.com
基金资助:
国家科技重大专项“艾滋病和病毒性肝炎等重大传染病防治”资助项目(编号:2018ZX10302205-005)

Clinical value of echocardiography in evaluating cardiac structure and function in patients with liver cirrhosis

Hu Xing, Meng Fankun, Han Jing, et al

Ultrasound and Functional Diagnosis Center, You’an Hospital, Capital Medical University, Beijing 10069, China

Received:2019-05-30 Online:2020-03-10 Published:2020-04-20

摘要/Abstract

摘要： 目的应用超声心动图检测肝硬化患者心脏相关参数,探讨患者心脏结构和功能的改变及其与终末期肝病严重程度的相关性。方法 2018 年 4 月~2019 年 4月我院诊治的124 例肝硬化患者(41例MELD 评分≤9 分为轻度)、35例为10≤MELD 评分≤19 分为中度和22例MELD≥20 分为重度)和60例健康人接受超声心动图检查,检测左房收缩末期内径(LAs)、左室舒张期末期内径(LVd)、右房收缩末期内径(RAs)、右室舒张末期内径(RVd)和左室射血分数(LVEF)。在组织多普勒成像(TDI)模式下检测二尖瓣环 Ea/Aa 比值,估算肝硬化患者肺动脉收缩压(PASP)。结果对照组和肝硬化组 LAs 分别为(36.3±3.1)和(37.8±4.3),LVd 分别为(47.8±2.8)和(49.4±4.6),Ea/Aa 比值分别为(1.1±0.3)和(1.0±0.2),均有显著性差异(P<0.05);轻度、中度和重度肝硬化患者LAs 分别为(36.1±4.2)、(38.2±4.1)和(40.1±3.7),LVd 分别为(47.4±4.5)、(50.3±4.4)和(51.4±3.8),PASP 分别为(31.2±4.6)、(33.4±4.5)和(35.1±5.4),差异显著(P<0.05);在124 例肝硬化患者中, 9 例(7.3%)PASP＞40mmHg,被判定为肺动脉高压(PAH)。结论随着肝病向终末期进展,肝硬化患者心脏结构和功能逐渐减退。超声心动图在评估肝硬化患者的心功能和估算肺动脉压方面具有敏感性高、可重复性强的有点,值得临床应用。

关键词: 肝硬化, 超声心动图, 心功能, 肺动脉高压

Abstract: Objective The aim of this study was to investigate the clinical value of echocardiography in evaluating cardiac structure and function in patients with liver cirrhosis (LC). Methods A total of 124 patients with liver cirrhosis and 60 healthy persons were recruited in this study between April, 2018 and April, 2019, and all underwent echocardiography. The model for end-stage liver disease (MELD) were calculated in patients with LC, and 41 were found to be mild with MELD score of ≤9, 35 moderate with 10≤MELD score ≤19, and 22 severe with MELD score ≥20. The cardiac parameters measured by echocardiography included left-atrial end-systolic diameter (LAs), left-ventricular end-diastolic diameter (LVd), right-atrial end-systolic diameter (RAs), right-ventricular end-diastolic diameter (RVd), left-ventricular ejection fraction (LVEF), and Ea/Aa ratio of mitral annulus by tissue Doppler imaging (TDI) mode, and the pulmonary artery systolic pressure (PASP) in cirrhotic patients was estimated. Results The LAs in the control group and in the cirrhosis group were (36.3±3.1) and (37.8±4.3), respectively, LVd were (47.8±2.8) and (49.4±4.6), respectively, and the Ea/Aa ratio were (1.1±0.3) and (1.0 ±0.2), respectively, all significantly different (P <0.05); In the mild, moderate, and severe groups of patients with liver cirrhosis, LAs were (36.1±4.2), (38.2±4.1), and (40.1±3.7), respectively, LVd were (47.4±4.5), (50.3±4.4) and (51.4±3.8), respectively, and PASP were (31.2±4.6), (33.4±4.5) and (35.1±5.4), respectively, all significantly different (P <0.05); out of the 124 patients with liver cirrhosis, 9 cases (7.3%) had PASP>40mmHg, diagnosed as having pulmonary hypertension (PAH) . Conclusion With the progression of end-stage liver disease, the function of the hearts in patients with liver cirrhosis gradually decrease, and echocardiography has the clinical application value with high sensitivity and repeatability in evaluating cardiac function and estimating pulmonary artery pressure in cirrhotic patients.

Key words: Liver cirrhosis, Echocardiography, Cardiac function, Pulmonary hypertension

胡星, 孟繁坤, 韩晶, 张旭辉. 应用超声心动图评估肝硬化患者心脏结构和功能临床价值研究^*[J]. 实用肝脏病杂志, 2020, 23(2): 252-255.

Hu Xing, Meng Fankun, Han Jing, et al. Clinical value of echocardiography in evaluating cardiac structure and function in patients with liver cirrhosis[J]. Journal of Practical Hepatology, 2020, 23(2): 252-255.

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应用超声心动图评估肝硬化患者心脏结构和功能临床价值研究^*

Clinical value of echocardiography in evaluating cardiac structure and function in patients with liver cirrhosis

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