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目的探讨实时三维超声心动图(RT-3DE)评价代谢综合征(MS)患者右室容积与收缩功能的临床价值,并分析代谢组分与右室射血分数(EF)的相关性。方法根据代谢组分数目将79例患者分为两组:前代谢综合征(Pre-MS)组(1~2项)35例,MS组(≥3项)44例;健康志愿者40例为对照组。应用RT-3DE技术测量右室舒张末期容积、收缩末期容积、每搏量(EDV、ESV、SV)以及EF,通过体表面积校正后计算右室舒张末期容积指数、收缩末期容积指数(EDVI、ESVI)。分析代谢组分与右室EF的相关性。结果与对照组比较,Pre-MS组和MS组右室EDV、ESV、EDVI、ESVI增加,EF降低(均P<0.05)。与Pre-MS组比较,MS组右室EDV、ESV、ESVI增加(均P<0.05);两组间EDVI、EF差异无统计学意义(均P>0.05)。右室EF与腰围(WC)、收缩压、空腹血糖(r=-0.78、-0.76、-0.54,均P<0.01)相关性较好,WC为EF独立预测因素(β=-0.49,r2=0.62,P<0.01)。结论 RT-3DE可准确反映右室容积变化,为定量分析MS患者右室收缩功能提供一种可靠检测手段;WC是MS代谢组分中影响右室EF的独立危险因素。
Objective To investigate the clinical value of real-time three-dimensional echocardiography (RT-3DE) in assessing right ventricular volume and systolic function in patients with metabolic syndrome (MS) and to analyze the correlation between metabolic components and right ventricular ejection fraction (EF). Methods According to the number of metabolic components, 79 patients were divided into two groups: pre-MS group (1 ~ 2 items) 35 cases, MS group (≥3 items) 44 cases; healthy volunteers 40 cases Control group. The right ventricular end-diastolic volume index, end-systolic volume index (EDVI, ESVI) were calculated by RT-3DE after right ventricular end-diastolic volume, end systolic volume, stroke volume (EDV, ESV, SV) ). The correlation between metabolic components and right ventricular EF was analyzed. Results Compared with the control group, the EDV, ESV, EDVI and ESVI of right ventricle in Pre-MS group and MS group were both increased and EF decreased (all P <0.05). Compared with Pre-MS group, EDV, ESV and ESVI of right ventricle increased in MS group (all P <0.05). There was no significant difference in EDVI and EF between the two groups (all P> 0.05). Right ventricular EF correlated well with WC, SBP, fasting blood glucose (r = -0.78, -0.76, -0.54, both P <0.01), WC was an independent predictor of EF (β = -0.49, r2 = 0.62, P <0.01). Conclusion RT-3DE can accurately reflect the changes of RV volume and provide a reliable means for quantitative analysis of right ventricular systolic function in patients with MS. WC is an independent risk factor of affecting right ventricular EF in MS metabolites.