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目的探讨职业性哮喘(OA)患者心脏心室收缩和舒张功能的变化及临床意义。方法以96例OA患者为病例组(轻、中、重度分别为56、30和10例,根据病程和病情程度分为轻度<5年亚组、轻度≥5年亚组、中重度<5年亚组、中重度≥5年亚组),以30名健康成年人为对照组,应用心脏彩色多普勒超声仪检测左右心室收缩和舒张功能指标变化情况并进行分析比较(上述检查在OA缓解期进行)。结果 1左心室:与对照组比较,轻度≥5年亚组、中重度<5年亚组以及中重度≥5年亚组左心室射血分数(LVEF)均下降(P<0.01),而射血前期与左心室射血期比值(PEP/LVET)和二尖瓣A峰血流速度(A peak)均升高(P<0.05);病例组4个亚组二尖瓣E峰血流速度(E peak)/A peak(E/A)均下降(P<0.05)。轻度≥5年亚组与轻度<5年亚组、中重度<5年亚组与轻度<5年亚组以及中重度≥5年亚组与中重度<5年亚组分别比较,LVEF和E/A均下降(P<0.05);PEP/LVET均升高(P<0.05);轻度≥5年亚组和中重度<5年亚组A peak分别高于轻度<5年亚组(P<0.05)。2右心室:与对照组比较,轻度≥5年亚组、中重度<5年亚组以及中重度≥5年亚组右心室射血前期/右心室射血期(RPEP/RVET)均升高(P<0.05),三尖瓣E峰血流速度(E’peak)均下降(P<0.05);病例组4个亚组三尖瓣环位移(TAD)、E’peak与三尖瓣A峰血流速度(A’peak)比值E’/A’均下降(P<0.05);轻度≥5年亚组与轻度<5年亚组、中重度<5年亚组与轻度<5年亚组以及中重度≥5年亚组与中重度<5年亚组分别比较,RPEP/RVET均升高(P<0.05);TAD和E’/A’均下降(P<0.05)。结论 OA患者在缓解期可能存在心室收缩和舒张功能受损,并随病程的延长和病情的加重而加重。
Objective To investigate the changes of cardiac ventricular systolic and diastolic function in patients with occupational asthma (OA) and its clinical significance. Methods A total of 96 patients with OA were selected as the case group (mild, moderate and severe were 56,30 and 10 cases, respectively, according to the duration and severity of disease were divided into mild <5 years, mild> 5 years subgroup, 5-year subgroup, moderate-severe subgroup ≥ 5 years), 30 healthy adults as the control group, the application of heart color Doppler ultrasound examination of left ventricular systolic and diastolic function index changes and analysis and comparison (the above examination in the OA Remission period). Results 1 Left ventricle: Compared with the control group, left ventricular ejection fraction (LVEF) in subgroups of mild ≥ 5 years, subgroup of moderate-severe 5 years, and subgroup of moderate-severe ≥ 5 years decreased (P <0.01) Pre ejection and left ventricular ejection fraction (PEP / LVET) and mitral A peak velocity (A peak) were increased (P <0.05); the four subgroups of mitral E group blood flow Epeak / Apeak (E / A) decreased (P <0.05). Mild sub 5-year and mild sub-5-year subgroups, moderate-sub 5-year subgroups and mild sub 5-year subgroups as well as moderate and severe sub- LVEF and E / A decreased (P <0.05), PEP / LVET increased (P <0.05), while A peak in mild ≥ 5-year and moderate-severe <5-year subgroups was higher than that in mild <5 years Subgroup (P <0.05). Right ventricle: Compared with the control group, the right ventricular ejection fraction (RVEP) / right ventricular ejection fraction (RPEP / RVET) in subgroups of mild ≥ 5 years, <5 years of moderate and severe subgroups, (P <0.05), and the E’peak of tricuspid valve decreased (P <0.05). TAD, E’peak and tricuspid valve (P <0.05). The A subgroup and mild subgroup <5 years with mild> 5 years subgroup, moderate and severe subgroup <5 years subgroup with mild RPEP / RVET were higher (P <0.05), TAD and E ’/ A’ were lower in <5-year subgroup, moderate-severe subgroup> 5-year subgroup and moderate- . Conclusions OA patients may have impaired ventricular systolic and diastolic function during remission, and aggravate with the prolongation of disease duration and aggravation of disease.