李越,李岩密,孟素云,温朝阳.Tei指数及相关基本参数评估不同左心室功能状态的研究[J].中国医学影像技术,2005,21(8):1205~1208
Tei指数及相关基本参数评估不同左心室功能状态的研究
Evaluating different left ventricular global performance by Tei index and correlative basic parameters
投稿时间:2005-05-13  修订日期:2005-07-23
DOI:
中文关键词:  Tei指数  超声心动描记术  心脏作功
英文关键词:Tei index  Echocardiography  Cardiac performance
基金项目:
作者单位E-mail
李越 中国人民解放军总医院超声诊断科,北京 100853 liyue@plagh.com.cn 
李岩密 中国人民解放军总医院超声诊断科,北京 100853  
孟素云 中国人民解放军总医院超声诊断科,北京 100853  
温朝阳 中国人民解放军总医院超声诊断科,北京 100853  
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中文摘要:
      目的 探讨Tei指数及相关基本参数评估左心室不同心功能状态的应用价值。方法 研究对象包括正常对照组(Ⅰ组)和3个病例组(Ⅱ、Ⅲ、Ⅳ组)共计74例患者。脉冲多普勒超声心动图采集二尖瓣和主动脉瓣血流频谱,首先测算出等容收缩时间(ICT)、等容舒张时间(IRT)以及射血时间(ET),并根据公式:Tei指数=(ICT+IRT)/ET进行计算。其中31例患者进行了双盲对照检测。结果 31例双盲检测Tei指数及相关参数在两个检查医师之间呈高度相关(r=0.92);配对t检验差异无显著性(P>0.05)。Tei指数按Ⅰ、Ⅱ、Ⅲ、Ⅳ组的顺序逐渐增大(0.35±0.08,0.59±0.20,0.72±0.21,0.79±0.29)。Ⅱ、Ⅲ、Ⅳ组Tei指数明显高于Ⅰ组,差异均有显著意义(P<0.05)。如以0.45作为正常值上限,Tei指数评估综合心功能减退的敏感性和特异性为76%和97%。Tei指数的各相关参数在Ⅰ组与病例组之间并不都存在显著差异,而且各相关参数在Ⅰ组到Ⅳ组之间的高低变化顺序不尽相同。Tei指数与各基本参数的相关性多为中度相关,其中以IRT/ET与Tei指数相关最好。结论 Tei指数是一种综合评估心功能敏感性、特异性和重复性较好的指标。与心功能综合状态受损的程度存在正比例变化关系。"单纯"舒张功能受损时,Tei指数表现为轻度增高。Tei指数的各相关基本参数对心功能也有一定评估作用,需酌情掌握分析使用。
英文摘要:
      Objective To explore the value of Tei index and correlative basic parameters for evaluating different left ventrivcular global performance. Methods Seventy-four patients with different left ventricular global performance were investigated. The patients included normal controls (group Ⅰ) and 3 abnormal groups (group Ⅱ, Ⅲ, Ⅳ). Mitral valve and aortic valve blood spectrum were obtained and measured by echocardiography. First measured and calculated the basic parameter, such as isovolumic contraction time (ICT), isovolumic relaxation time (IRT), ejection time (ET). Then Tei index were calculated according the formula: Tei index = (ICT+IRT) divided by ET. In the seventy-four patients there were thirty-one were studied in both blind condition. Results Between the both blind examinator Tei index and related indices showed a close correlation, and the mean±standard divination were not significantly different (P>0.05). According sequence from group Ⅰ to group Ⅳ Tei index gradually increased (0.35±0.08,0.59±0.20,0.72±0.21,0.79±0.29). In group Ⅱ, Ⅲ, Ⅳ, Tei index were obvious higher than group Ⅰ(P<0.05). If use 0.45 as upper bound of normal value, the sensitivity and specificity of Tei index for diagnosing of abnormal left ventricular global function were 0.76 and 0.97. The basic parameters were not always show significantly different between group Ⅰ and other 3 groups. Moreover, increasing or decreasing sequences from group Ⅰ to group Ⅳ in every basic parameter was different. There was a moderate correlation between Tei index and basic parameters. The best correlation was between Tei index and IRT/ET. Conclusion The repeatability, sensitivity and specificity of Tei index are very useful in evaluating global left ventricular performance. The value of Tei index shows a direct proportion to the degree of heart failure and is mildly increased in the isolated diastolic dysfunction. The basic parameters that relate to Tei index are valuable for evaluating heart function. But it should be applied accordingly.
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