超声斑点追踪联合Tei指数评估BiPAP通气对左心衰患者左室功能的影响

Ultrasound Speckle Tracking Combined with Tei Index in Evaluating the Effects of BiPAP Ventilation on Left Ventricular Function of Patients with Left Heart Failure

摘要: 目的：探讨超声斑点追踪联合Tei指数评估BiPAP通气对左心衰患者左室功能的影响。方法：选取2016年4月~2018年5月本院收治的70例左心衰患者为研究对象，随机分为对照组(实施普通双鼻导管吸氧，n = 35)和观察组(实施BiPAP通气治疗，n = 35)，治疗前后两组患者均进行超声斑点追踪、Tei指数检查，比较两组治疗前后心率、呼吸频率、血气指标[动脉血氧分压(PaO₂)、末梢血氧饱和度(SaO₂)]，左室功能指标[舒张期左心室后壁厚度(LVPWD)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)]和Tei指数，同时对Tei指数与左心衰患者左室功能进行相关性分析。结果：治疗前两组心率、呼吸频率、PaO₂、SaO₂、Tei指数、LVPWD、LVEDD、LVEF、GLS、GRS、GCS、GAS相较无明显差异(P > 0.05)；与治疗前相较，治疗后两组心率、呼吸频率、LVPWD、LVEDD、GLS、GCS、GAS明显降低，PaO₂、SaO₂、LVEF、GRS明显升高，且治疗后观察组心率、呼吸频率、LVPWD、LVEDD、GLS、GAS、Tei指数明显低于对照组，PaO₂、SaO₂、LVEF明显高于对照组(P < 0.05)。Tei指数与左心衰患者的LVPWD、LVEDD呈明显正相关，与LVEF呈明显负相关(r = 0.299, 0.312, −0.309, P < 0.05)， 、 与左心衰患者的LVPWD、LVEDD呈明显负相关，与LVEF呈明显正相关(P < 0.05)。结论：BiPAP通气是左心衰患者有效治疗方案，可明显改善患者心率/呼吸频率及左室功能，超声斑点追踪联合Tei指数可有效评估BiPAP通气对左心衰患者左室功能的影响。

Abstract: Objective: To explore ultrasound speckle tracking combined with Tei index in evaluating the effects of BiPAP ventilation on left ventricular function of patients with left heart failure. Methods: 70 cases of patients with left heart failure admitted to our hospital from April 2016 to May 2018 were selected for the study and were randomly divided into control group (given common oxy-gen-absorbing by nasal trachea, n = 35) and observation group (given BiPAP ventilation therapy, n = 35). The two groups were given ultrasound speckle tracking and Tei index before and after treatment. The heart rate, respiratory rate and blood gas indexes [arterial partial pressure of ox-ygen (PaO₂), peripheral blood oxygen saturation (SaO₂)], left ventricular function indexes [diastolic left ventricular posterior wall thickness (LVPWD), left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF)] and Tei index were compared between the two groups before and after treatment. And Tei index and left ventricular function in patients with left heart failure were given correlation analysis. Results: There were no significant differences in heart rate, respiratory rate, PaO₂, SaO₂, Tei index, LVPWD, LVEDD, LVEF, GLS, GRS, GCS and GAS between the two groups before treatment (P > 0.05). Compared with before treatment, the heart rate, respiratory rate, LVPWD, LVEDD, GLS, GCS and GAS after treatment in the two groups were significantly decreased while the PaO₂, SaO₂, LVEF and GRS were increased significantly, and the heart rate, respiratory rate, LVPWD, LVEDD, GLS, GAS and Tei index in observation group were significantly lower than those in control group after treatment while the PaO₂, SaO₂ and LVEF were significantly higher than those in control group (P < 0.05). The Tei index was positively correlated with LVPWD and LVEDD in patients with left heart failure, and negatively correlated with LVEF (r = 0.299, 0.312, −0.309, P < 0.05). And the and were significantly negatively correlated with LVPWD and LVEDD in patients with left heart failure, and positively correlated with LVEF (P<0.05). Conclusions: BiPAP ventilation is an effective treatment regimen for patients with left heart failure. And it can significantly improve heart rate, respiratory rate and left ventricular function. Ultrasound speckle tracking combined with Tei index can effectively evaluate the effects of BiPAP ventilation on left ventricular function in patients with left heart failure.