Echocardiographic Evaluation Of Right Ventricular Function And The Analysis Of Risk Factors Of Right Ventricular Dysfunction In Patients With Stage I Pneumoconiosis

Objective: To evaluate the right ventricular function of pneumoconiosis stage I by echocardiography,and to explore the situation and influencing factors of right ventricular dysfunction(RVD)in stage I pneumoconiosis.Methods: using simple random sampling method,91 cases of pneumoconiosis patients in stage I treatment in the Guangxi Zhuang Autonomous Region work’s hospital from September 2014 to August 2017 for pneumoconiosis group and those subjects were chosen by the hospital diagnosis of pneumoconiosis group diagnosed pneumoconiosis patients in stage I;another91 cases selected age,not exposed to dust gender,logistics or administrative staff as the control group.The relevant clinical data of the two groups,echocardiography for right ventricular function using ultrasound: right ventricular index of myocardial performance(RIMP),right ventricular lateral wall tricuspid annular plane systolic excursion(TAPSE);measuring tricuspid regurgitation velocity(TRV)estimation of pulmonary artery systolic pressure(SPAP).Calculation of two groups RVD prevalence,pulmonary hypertensionprevalence rate and general data analysis and comparison;according to whether TAPSE<17mm and(or)RIMP>0.54,the pneumoconiosis stage I were divided into RVD subgroup and non RVD subgroup,comparative analysis of age and cumulative exposure time,duration,dust removal time of respiratory diseases,complications,treatment,lung if there is a function,pulmonary hypertension,smoking history,body height,body mass,dust type,working environment,whether the dry wet operation were the influencing factors of pneumoconiosis patients in stage one with RVD.Results: There were 27 cases with RVD in pneumoconiosis group,and 4cases with RVD in control group,there were 3 cases of pneumoconiosis group with pulmonary hypertension,and no pulmonary hypertension in control group.The prevalence of RVD in pneumoconiosis group was higher than that in the control group(29.7% vs 4.4%),the difference was statistically significant(P<0.05).There was no significant difference in the prevalence of gender,age,smoking history,drinking history and pulmonary hypertension between the pneumoconiosis group and the control group(P>0.05).Pneumoconiosis in the group of RVD subgroup and non RVD subgroups compared to age and cumulative exposure time,duration of respiratory diseases,complications,treatment of lung function,the difference was statistically significant(P<0.05);gender,height,body mass,dust removal time,whether there is a history of smoking,pulmonary hypertension,dust the categories,working environment,whether dry operation had no significant difference(P>0.05).The above 15 factors as independent variables by univariate Logistic regression analysis,the factors of P < 0.1 included in the multivariate Logistic regression analysis showed that age,disease of respiratory system complications are independent risk factors for RVD(odds ratio were 1.077,12.470,P<0.05).Trend chi squareanalysis showed that the prevalence of RVD increased with the increase of age(the Chi-square value were 14.413,P<0.05).Conclusion: the early stage of pneumoconiosis(stage I)a certain proportion of patients with right ventricular dysfunction,echocardiographic indexes of RIMP,TAPSE can detect whether patients with right ventricular dysfunction,provide the basis for clinical diagnosis and treatment of early diagnosis and early intervention;age,disease of respiratory system complications are independent risk factors of right ventricular dysfunction in patients with pneumoconiosis in stage one;should be carried on prevention and intervention,delaying the progress of right heart function damage.