矫正的主动脉血流参数评价左心室收缩功能的价值  

Role of corrected parameters of aortic blood flow in evaluating left ventricular systolic function

作　　者：徐冬梅[1] 范崇伦[2] 张梅[3] 姜洪菊[4] 

机构地区：[1]山东省济南市第三人民医院心内科,现为250101 [2]山东省济南市中心医院呼吸内科 [3]山东省齐鲁医院心内科 [4]山东省济南市铁路中心医院心内科

出　　处：《中华医学超声杂志（电子版）》2006年第6期345-348,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨矫正的主动脉血流参数在充血性心力衰竭患者治疗前后的变化规律及其与NYHA心功能分级的关系。方法以本院34例心力衰竭患者为心力衰竭组,并以24例正常人为对照组,采用彩色多普勒超声显像仪取心尖四腔心切面,采集左心室收缩末期和舒张末期图像,用单平面Simpson法计算受检者左心室射血分数(LVEF);取心尖五腔心切面,采用脉冲多普勒超声测量从主动脉瓣环水平与主动脉峰值流速同一时相的最大流速(VP1),计算主动脉血流当地平均加速度(MAC),并用收缩末期左心室容积(ESV)和主动脉瓣环面积(AOA)与收缩末期左心室中部截面积(ESA)之比(AOA/ESA)分别矫正VP1和MAC,即VP1/ESV、MAC/ESV、VP1·AOA/ESA和MAC·AOA/ESA,观察治疗前后以上测量指标的变化及其与美国纽约心脏病协会(NYHA)心功能分级的关系。结果心力衰竭组与对照组相比,矫正的主动脉血流参数,即VP1/ESV、MAC/ESV、VP1·AOA/ESA和MAC·AOA/ESA均显著降低(P<0.01),心力衰竭组治疗后上述指标均较治疗前改善(P<0.01)。LVEF与NYHA心功能分级呈弱负相关(rs=-0.46),矫正的主动脉血流参数与心功能分级呈中度负相关(rs=-0.60,rs=-0.67,rs=-0.74,rs=-0.62)。结论矫正的主动脉血流参数能够反映充血性心力衰竭患者左心室收缩功能的变化,与LVEF相比,其与NYHA心功能分级的关系更密切。ObjectiveTo study the changes of the corrected parameters of aortic blood flow in the patients with congestive heart failure before and after treatment. To explore the correlation between left ventricular ejection (LVEF), the parameters mentioned above and cardiac functional class. MethodsThirty-four consecutive patients with a clinical diagnosis of congestive heart failure (CHF) were studied as CHF group and 24 normal subjects were selected as the control group. Using two-dimentional and pulsed Doppler echocardiography, we measured the corrected parameters of aortic blood flow (VP1/ESV,MAC/ESV, VP1·AOA/ESA and MAC·AOA/ESA) before and after treatment. ResultsCompared with healthy controls, VP1/ESV, MAC/ESV, VP1·AOA/ESA and MAC·AOA/ESA of congestive heart failure group were significantly reduced (P<0.01, respectively) . The parameters mentioned above were significantly increased after treatment (P<0.01, respectively). VP1/ESV, MAC/ESV, VP1·AOA/ESA and MAC·AOA/ESA had a better linear correlation to functional class (rs=-0.60, rs=-0.67, rs=-0.74, rs=-0.62) , but LVEF had a weak liner correlation to cardiac functional class (rs=-0.46) . ConclusionsThe corrected parameters of aortic blood flow may assess the changes of left ventricular systolic function correctly . Compared with LVEF, there are more close correlations between these parameters and cardiac functional class.

关 键 词：彩色多普勒超声检查 充血性心力衰竭 左心室功能 

分 类 号：R541.61[医药卫生—心血管疾病]