三种超声心动图经验公式评估高原某部官兵肺动脉压的比较

吴赤球, 林海平, 余丹, 严许清, 梅朵卓嘎

武警医学 ›› 2023, Vol. 34 ›› Issue (1) : 1-4.

PDF(1642 KB)
PDF(1642 KB)
武警医学 ›› 2023, Vol. 34 ›› Issue (1) : 1-4.
论著

三种超声心动图经验公式评估高原某部官兵肺动脉压的比较

  • 吴赤球1, 林海平2, 余丹3, 严许清4, 梅朵卓嘎4
作者信息 +

Comparison of different empirical formula of echocardiography in evaluating pulmonary artery pressure in highland population

  • WU Chiqiu1, LIN Haiping2, YU Dan3, YAN Xuqing4, MEIDUO Zuoga4
Author information +
文章历史 +

摘要

目的 比较三种超声心动图经验公式测量高原某部官兵肺动脉压的差别。方法 对驻扎在高原(海拔4000~5000 m)某部105名官兵进行系统超声心动图检查,应用三种超声心动图经验公式测量平均肺动脉压,公式1(F1):平均肺动脉压(MPAP)=0.62×肺动脉收缩压(PASP)+2 mmHg;公式2(F2):MPAP=79-0.45×肺动脉加速时间(PAAT);公式3(F3):MPAP=90-0.61×PAAT,并比较各结果之间的差异。结果 (1) 105名中观察到三尖瓣反流者87名,占82.86%,获得满意频谱能进行三尖瓣频谱测量并计算肺动脉收缩压者75名,占71.43%。全部受检者均获得满意肺动脉血流频谱并能进行有效PAAT测量。应用公式F1、F2、F3测量的MPAP分别为(22.35±5.19) mmHg、(29.57±5.55)mmHg、(22.51±7.08) mmHg。其中F2与F1结果相比差异有统计学意义(P<0.01)。(2) Pearson相关分析,公式F1与F2检测结果相关系数r=0.53(P<0.01),公式F1与F3检测结果相关系数r=0.59(P<0.01)。Bland-Altman 分析,公式F1与F2检测结果偏倚为-7.22 mmHg,95%的一致性界限为(-17.40,2.97)mmHg。公式F1与F3检测结果偏倚为-0.16 mmHg,95%的一致性界限为(-11.58,11.27)mmHg。二者95%的一致性界限外点数占1.33%(1/75)。结论 公式F2和F3,与公式F1所测高原人群MPAP结果均呈中度相关,但公式F3和F1所测结果之间偏倚更小,一致性更好。

Abstract

Objective To assess the differences of pulmonary artery pressure measured by different empirical formula of echocardiography in highland population. Methods A total of 105 officers and soldiers stationed at altitudes of 4000 m~5000 m were included in the study, and three kinds of echocardiography were performed by an experienced sonographer.The mean pulmonary arterial pressure(MPAP) were measured by Formula 1,MPAP=0.62×pulmonary arterial systolic pressure(PASP)+2 mmHg, Formula 2,MPAP=79-0.45×pulmonary artery acceleration time(PAAT)and Formula 3,MPAP=90-0.61×PAAT. Results Tricuspid regurgitant flow could be identified in approximately 82.86%(87/105) of the healthy subjects, and 71.43%(75/105) of the subjects could be obtained satisfactory tricuspid regurgitation to allow PASP estimation, while 100% subjects(105/105) could be obtained satisfactory pulmonary artery flow spectrum to allow MPAP estimation.The mean pulmonary arterial pressures measured by F1,F2 and F3 were (22.35±5.19) mmHg,(29.57±5.55) mmHg and (22.51±7.08) mmHg respectively. The parameters of F2 was statistically different from F1, P<0.01). Pearson correlation analysis showed that the correlation coefficient was 0.53 between F1 and F2,while the correlation coefficient was 0.59 between F1 and F3.Bland-Altman consistency analysis showed that the test results bias of F1 and F2 was -7.22 mmHg, and the 95% consistency limit was (-17.40,2.97) mmHg, while the test results bias of F1 and F3 was -0.16 mmHg, the 95% consistency limit was (-11.58,11.27) mmHg. and the maximum points out(ratio)was 1.33%(1/75) in these two methods. Conclusions Mean pulmonary arterial pressures of plateau population measured by the two empirical formulas derived from PAAT are moderately correlated with the empirical formula derived from tricuspid regurgitation, and there is a good consistency for MPAP measurement between F1 and F3.

关键词

超声心动图 / 高原 / 肺动脉压 / 经验公式

Key words

echocardiography / highland / pulmonary artery pressure / formula

引用本文

导出引用
吴赤球, 林海平, 余丹, 严许清, 梅朵卓嘎. 三种超声心动图经验公式评估高原某部官兵肺动脉压的比较[J]. 武警医学. 2023, 34(1): 1-4
WU Chiqiu, LIN Haiping, YU Dan, YAN Xuqing, MEIDUO Zuoga. Comparison of different empirical formula of echocardiography in evaluating pulmonary artery pressure in highland population[J]. Medical Journal of the Chinese People Armed Police Forces. 2023, 34(1): 1-4
中图分类号: R540.4    R445.1   

参考文献

[1] Stembridge M,Philip N,Rob Shave, et al. Ventricular structure, function, and mechanics at high altitude: chronic remodeling in sherpa vs. short-term lowlander adaptation[J].J Exp Physiol, 2015, 100(11):1242-1246.
[2] 中华医学会超声医学分会超声心动图学组.中国成年人超声心动图检查测量指南[J].中华超声影像学杂志, 2016, 25(8):645-666.
[3] Lang R M, Badano L P, Mor-Avi V, et al. Recommendations for cardiac chamber quantifification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging[J]. J Am Soc Echocardiogr, 2015, 28(1):1-39.
[4] Chemla D, Castelain V, Humbert M, et al. New formula for predictingmean pulmonary artery pressure using systolic pulmonary artery pressure[J].Chest, 2004, 126(4):1313-1317.
[5] Mahan G, Dabestani A, Gardin J, et al. Estimation of pulmonary artery pressure by pulsed doppler echocardiography[J]. Circulation, 1983, 68(2):367.
[6] Dabestani A, Mahan G, Gardin J M, et al. Evaluation of pulmonary artery pressure and resistance by pulsed doppler echocardiography[J]. Am J Cardiol, 1987, 59(6):662-668.
[7] Rodrigo S, Matthias E, Urs S, et al. Pulmonary artery pressure and arterial oxygen saturation in people living at high or low altitude: systematic review and meta-analysis[J].J Appl Physiol, 2016, 121(5):1151-1159.
[8] Guyue Liu, Liming Zhao, Qing Xu, et al. Cardiac adaptation to high altitudes after short-and long-term exposure among chinese han lowlanders[J]. Echocardiography, 2022,39(3):465-472.
[9] Akylbek S,Argen M,Abdirashit M, et al. Pulmonary hypertension in acute and chronic high altitude maladaptation disorders[J]. Int J Environ Res Public Health, 2021,18(4):1692.
[10] Galiè N, Humbert M, Vachiery J L, et al. 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension[J].Eur Heart J, 2016, 69(2): 67-119.
[11] 中华医学会呼吸病学分会肺栓塞与肺血管病学组.中国肺动脉高压诊断与治疗指南(2021版)[J].中华医学杂志, 2021, 101(1):11-51.
[12] Yock P G, Popp R L. Noninvasive estimation of right ventricular systolic pressure by doppler ultrasound in PAA tients with tricuspid regurgitation[J]. Circulation, 1984, 70(4):657-662.
[13] Luca L,Alessandra F,Elena L, et al. Noninvasive estimation of both systolic and diastolic pulmonary artery pressure from Doppler analysis of tricuspid regurgitant velocity spectrum in patients with chronic heart failure[J], Am Heart J,2002,144(6):1087-1094.
[14] Soofi M A, Shah M A, AlQadhi A M,et al. Sensitivity and specificity of pulmonary artery pressure measurement in echocardiography and correlation with right heart catheterization[J].J Saudi Heart Assoc,2021,33(3):228-236.
[15] Steckelberg R C, Tseng A S, Nishimura R, et al. Derivation of mean pulmonary artery pressure from noninvasive parameters[J].J Am Soc Echocardiogr, 2013, 26(5):464-468.
[16] Muhammad A S, Muhammad S H, Ammar M A, et al.Sensitivity and specificity of pulmonary artery pressure measurement in echocardiography and correlation with right heart catheterization[J]. J Saudi Heart Assoc,2021, 33(3):228-236.
[17] Mona L, Stéphanie S, Michael F, et al.Cardiac function and pulmonary hypertension in central Asian highlanders at 3250 m[J].Eur Respir J, 2020, 56(2):1902474.
[18] 王 勇, 刘 勇, 潘 磊. 超声心动图在急进高原人员心室功能评价中的应用[J].首都医科大学学报,2013, 34(6):891-893.
[19] Kristian H,Bernhard U,Sitali M B, et al. Echocardiographic estimation of mean pulmonary artery pressure: a comparison of different approaches to assign the likelihood of pulmonary hypertension[J]. J Am Soc Echocardiogr,2018,31(1):89-98.
[20] Stéphane D,Matthieu C,Irina E, et al. Right heart hemodynamics in pulmonary hypertension-an echocardiography and catheterization study[J].Circulation, 2016, 80(9):2019-2025.

PDF(1642 KB)

Accesses

Citation

Detail

段落导航
相关文章

/