Study On Relationship Between Changes Of Echocardiographic Righe Ventricular Function And Pulmonary Hemodynamics And Levels Of D-plasma And Fibrinogen In Pneumoconiosis Patients

Object: To explore the correlation between changes of echocardiographic right ventricular functional indexes , pulmonary hemodynamic parameters and levels of D- plasma and fibrinogen in pneumoconiosis patients .Methods: 116 male inpatients with pneumoconiosis, according to with or without chronic pulmonary heart disease, was divided into simple pneumoconiosis group (80 cases) and pneumoconiosis combined chronic pulmonary heart disease group (36 cases). Forty healthy male volunteers were chosen as the control group. All subjects were examined by transthoracic echocardiography. The right heart morphological indexes were measured, the right heart function index: myocardial performance index(Tei index) and tricuspid annular plane systolic excution(TAPSE) were acquired, pulmonary hemodynamic parameters: pulmonary artery systolic pressure(PASP) and pulmonary vascular resistance (PVR) were calculated. The pulmonary artery acceleration time/right ventricular ejection time (PAAT/RVET) was measured.Meanwhile, the laboratory indexes of plasma D-dimer (D-D) and fibrinogen(Fib) levels,which reflect coagulation and fibrinolytic activity in the body, were detetcted.Result: 1. The morphology and right heart function index: Compared with the control group and simple pneumoconiosis group, the indexes of MPA,RVOT, RV and Tei index were higher and the TAPSE was lower in pneumoconiosis combined chronic pulmonary heart disease group (P<0.05 ).Compared with the control group, the indexes of MPA, RVOT, RV and Tei index were higher, and the index of TAPSE was lower in simple pneumoconiosis group (P<0.05) . There were no statistical significance difference between simple pneumoconiosis group and control group of the indexes in MPA and RV (P>0.05) .2. Pulmonary hemodynamic parameters:The indexes of PASP and PVR in pneumoconiosis combined chronic pulmonary heart disease group and simple pneumoconiosis group were higher than the control group (P<0.05 ) , and were significantly increased in pneumoconiosis combined chronic pulmonary heart disease group (P<0.05) . The indexe of PAAT/RVET in pneumoconiosis combined chronic pulmonary heart disease group and simple pneumoconiosis group was lower than the control group, and there was no significant difference between the simple pneumoconiosis group and the pneumoconiosis combined chronic pulmonary heart disease group (P>0.05). 3. Laboratory indicators: Compared with the control group and simple pneumoconiosis group, the levels of D-dimer and fibrinogen were higher in pneumoconiosis combined chronic pulmonary heart disease group (P< 0.05).The levels of D-dimer in simple pneumoconiosis group was higher than the control group, but there were no statistical significance difference in the levels of fibrinogen (P>0.05) 4. Correlation analysis: the Tei index was positive correlated to the PVR and PASP with statistical significance (r= 0.62.0.57 ) (P<0.05) , and TAPSE was negative correlated to the PVR and PASP with statistical significance (r= - 0.55. - 0.55) (P<0.05). The blood D-dimer levels had correlation with the PVR and PASP with statistical significance ( r= 0.43 ?0.40)(P<0.05).Conclusion: 1. Transthoracic echocardiography could not only evaluate pneumoconiosis patients's right heart morphological change , the Tei index and TAPSE , but also sensitively discover the change of the right ventricle function.2. Transthoracic echocardiography can monitor pneumoconiosis patients at different stages of the change of pulmonary hemodynamic parameters , yet to some extent, can reflect right heart function damage. 3. Pneumoconiosis patients have high coagulation state and abnormal fibrinolysis activity, which may be one of the factors of pulmonary hemodynamic change.