目的探讨超声心动图技术对急性肺栓塞治疗效果的评价作用。方法选择我院诊治的急性肺栓塞48例,分别于治疗前,治疗后3、6、12个月做超声心动图检查,测量指标包括右室横径(RVD)、左室横径(LVD)、右房横径(RAD)、左房横径(LAD)、肺动脉主干内径(MPAD)、三尖瓣反流压差(PGTR)、计算右房横径/左房横径(RATD/LATD)、右室横径/左室横径(RVD/LVD)及肺动脉收缩压(SPAP)。比较以上指标在不同时点的变化。结果在溶栓和(或)抗凝治疗3个月时,SPAP[(38.64±11.33)vs(49.86±19.61)]、RA/LA[(1.01±0.28)vs(1.11±0.33)]与治疗前比较,改善最为明显(均P＜0.01);至6个月、12个月时,改善幅度变小。在溶栓和(或)抗凝治疗3、6、12个月时,RV/LV与治疗前比较,均有明显改善(P＜0.01或P＜0.05);而MPAD、LVEF在治疗前后,以及随诊观测中均没有变化,差异无统计学意义(P＞0.05)。全部患者随访12个月后,4例进展为慢性血栓栓塞性肺动脉高压(chronic thromboembolic pulmonary hypertension,CTEPH)。结论超声心动图可以作为评价急性肺栓塞疗效的无创实用技术。

Objective To evaluate the application of echocardiography technology for the treatment of acute pulmonary embolism effect evaluation. Methods Between February 2009 and November 2013,from departments of respiratory medicine and cardiology in Armed Police hospital, 48 patients with acute pulmonary embolism were recruited. In thrombolysis and anticoagulation therapy before and after treatment for 3 months,6 months and 12 months, echocardiography was conducted. Measure indicators including right ventricular diameter (RVD),left ventricular diameter(LVD),right atrial diameter (RAD), left atrial diameter (LAD),main pulmonary artery diameter (MPAD), pressure gradient of tricuspid valve regurgitation(PGTR), right ventricular anterior wall motion(RVAWM), RVD/LVD、RAD/LAD and SPAP, were calculated. Results SPAP with RA/LA improvement was most obvious when anticoagulation in March . As time went on, change was not obvious. After anticoagulant treatment for 3 month and 6 month, the RV/LV obviously improved,there were still changes after treatment for 12 months.MPAD and EF had no changes before and after treatment and follow-up. After follow-up of all 48 patients for 12 months, 4 patients had chronic thromboembolic pulmonary hypertension. Conclusions Echocardiogaphy can be used as a practical technology for noninvasive evaluation of curative effect on acute pulmonary embolism.