三尖瓣环收缩期位移/肺动脉收缩压比值与脓毒性心肌病的相关性分析

Correlation Analysis of Tricuspid Annular Plane Systolic Excursion/Pulmonary Arterial Systolic Pressure Ratio with Sepsis-Induced Cardiomyopathy

摘要: 目的：探讨TAPSE/PASP比值在脓毒性心肌病患者中的诊断、评估作用。方法：选取2021年11月~2022年10月入住唐山市工人医院ICU1的脓毒症患者为研究对象，将发生脓毒性心肌病者纳入脓毒性心肌病组(SIC组)，未发生脓毒性心肌病者纳入无脓毒性心肌病组(无SIC组)，比较SIC组与无SIC组患者不同时间内的超声心动图参数、血流动力学参数变化。结果：SIC组患者的TAPSE/PASP比值明显低于无SIC组，差异有统计学意义(P < 0.001)。结论：脓毒性心肌病患者中的右心室–肺动脉偶联指标明显低于无脓毒性心肌病患者的相应指标，故脓毒性心肌病发病过程中存在明显的右心室–肺动脉偶联变化(P = 0.006)，即TAPSE下降(P < 0.001)、LVEF下降(P < 0.001)、VTI下降(P < 0.001)、CVP上升(P < 0.001)。明显，可通过大样本研究进行进一步观察。

Abstract: Objective: To explore the role of TAPSE/PASP ratio in the diagnosis and evaluation of patients with septic cardiomyopathy. Methods: The sepsis patients who were admitted to ICU1 of Tangshan Workers’ Hospital from November 2021 to October 2022 were selected as the research objects. The patients with septic cardiomyopathy were included in the septic cardiomyopathy group (SIC group), and the patients without septic cardiomyopathy were included in the non septic cardiomyopathy group (no SIC group). The changes of echocardiography parameters and hemodynamics parameters were compared between the SIC group and the non SIC group at different times. Results: The TAPSE/PASP ratio in SIC group was significantly lower than that in non SIC group, with a statistical-ly significant difference (P < 0.001). Conclusion: The right ventricular pulmonary artery coupling index in patients with septic cardiomyopathy was significantly lower than that in patients with non septic cardiomyopathy, so there were significant changes in right ventricular pulmonary artery coupling during the onset of septic cardiomyopathy (P = 0.006), that is, TAPSE decreased (P < 0.001), LVEF decreased (P < 0.001), VTI decreased (P < 0.001) and CVP increased (P < 0.001) signif-icantly, which can be further observed through large sample study.