目的 探讨全自动三维超声右心室定量（3D Auto RV）评估慢性肺源性心脏病（CPHD）患者右室收缩功能的临床价值。方法 根据临床表现将 88 例 CPHD 患者分为代偿组（48 例）和失代偿组 （40 例），另选取健康对照组 40 例。测量受试者常规超声参数，并应用 3D Auto RV 测量右室舒张末期容积 （RVEDV）、右室收缩末期容积（RVESV）、右室每搏输出量（RVSV）、右室射血分数（RVEF）、三尖瓣环收缩期 位移（TAPSE）、右室面积变化率（RVFAC）、右室的游离壁纵向应变（FWLS）和室间隔纵向应变（SLS），比较 各组间差异。结果 （1）与对照组比较，CPHD 各组 TAPSE、RVFAC、RVEF、FWLS 及 SLS 均减低，RVEDV、 RVESV 均增大（P < 0.05）；失代偿组 RVSV 较对照组及代偿组均减低（P < 0.05），代偿组 RVSV 与对照组比 较无明显差异（P > 0.05）。与代偿组相比，失代偿组TAPSE、RVFAC、RVEF及FWLS均进一步减低，RVEDV、 RVESV 均进一步增大（P < 0.05），RVSLS 差异无统计学意义（P > 0.05）。（2）FWLS 与 RVEF 相关性较高 （r = -0.721，P < 0.001）。（3）RVEF 预测 CPHD 失代偿期的最佳截断值为 41.35%（AUC = 0.95，P < 0.001）。 （4）重复性检验显示 RVEF 和 FWLS 具有良好的重复性。结论 3D Auto RV 能够准确评价 CPHD 患者的右 室收缩功能，有望成为临床评估CPHD 患者病情程度的新方法。

Objective To investigate the clinical value of fully automated three⁃dimensional echocardiog⁃ raphy right ventricular quantification software（3D Auto RV）in evaluating right ventricular systolic function in patients with chronic pulmonary heart disease（CPHD）. Methods According to clinical manifestations，88 patients with CPHD were divided into the compensated group（n = 48）and the decompensated group（n = 40），and 40 healthy subjects served as controls. To measure the routine ultrasound parameters of the subjects ，and apply 3D Auto RV measures right ventricular end ⁃ diastolic volume（RVEDV），right ventricular end ⁃ systolic volume （RVESV），right ventricular stroke volume（RVSV），right ventricular ejection fraction（RVEF），tricuspid annular plane systolic excursion（TAPSE），right ventricular fractional area change（RVFAC），longitudinal strain of free wall（FWLS），longitudinal strain of ventricular septum（SLS），and the difference among groups were compared. Results （1）Compared with the control group，TAPSE，RVFAC，RVEF，FWLS and SLS were decreased，while RVEDV and RVESV were increased in CPHD groups（P < 0.05）. The RVSV of the decompensated group was significantly lower than that of the control group and the compensated patients（P < 0.05），but there was no sig⁃ nificant difference between the compensatory group and the control group（P > 0.05）. Compared with the compensated group，TAPSE，RVFAC，RVEF and FWLS were further decreased，RVEDV and RVESV were further increased in the decompensated group（P < 0.05），and SLS had no significant difference（P > 0.05）.（2）FWLS had a high correlation with RVEF（r = -0.721，P < 0.001）.（3）The optimal cut⁃off value of RVEF for predicting the decompensated phase of CPHD was 41.35%（AUC = 0.95，P < 0.001）.（4）Repeatability test showed that both RVEF and FWLS had good repeatability. Conclusion 3D Auto RV can accurately evaluate the right ventricularsystolic function in patients with CPHD，which is expected to become a new method for clinical evaluation of the severity of CPHD.