肺静脉与二尖瓣血流频谱A峰速度比值评价左心室收缩功能不全患者左心舒张功能的研究  

Ratio of pulmonary venous A to mitral A velocity for evaluation of LV diastolic function in patients with left ventricular systolic dysfunction

作　　者：李华[1] 陈晓峰[1] 

机构地区：[1]新疆医科大学附属中医医院心脏超声诊断科,乌鲁木齐830000

出　　处：《中华医学超声杂志（电子版）》2007年第6期342-344,共3页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨肺静脉与二尖瓣血流频谱A峰速度比值(PV-A/A)在评价左心室收缩功能不全患者左心舒张功能中的价值。方法46例左心室收缩功能不全患者及15例左心室收缩功能正常者分别作为研究组和对照组,根据Simpson法测量的左心室射血分数(LVEF)将研究组分为3个亚组,15例轻度左心收缩功能不全(组Ⅰ)LVEF为40%～50%,14例中度左心收缩功能不全(组Ⅱ)LVEF为30%～39%,17例重度左心功能收缩不全(组Ⅲ)LVEF为20%～29%。采用经胸超声检测受检者二尖瓣口舒张早期E峰速度、舒张晚期A峰速度,计算E峰速度和A峰速度比值(E/A);检测肺静脉舒张晚期A峰速度(PV-A),并计算PV-A/A值。结果研究组LVEF与对照组相比均降低(P<0.01),以组Ⅲ最低。组Ⅲ二尖瓣口血流频谱E峰速度较组Ⅰ和组Ⅱ增高(P<0.01或0.05)。组Ⅲ中二尖瓣口A峰流速较其他组明显降低(P<0.01或P<0.05),而组Ⅰ中A峰流速最高。组Ⅲ的E/A值较其他3组增高(P<0.01)。PV-A值在组Ⅰ、组Ⅲ和对照组间差异无统计学意义,组Ⅱ的PV-A值较其他组增高(P<0.01或P<0.05)。组Ⅲ的PV-A/A较其他组明显增高(P<0.01或P<0.05)。结论PV-A/A能够反映左心室收缩功能不全时左心室充盈压力的增高,可较准确地评价左心室收缩功能不全时的左心舒张功能。Objective To evaluate the value of the ratio of pulmonary venous A to mitral A velocity(PV-A/A) in diastolic function assessment in patients with left ventricular(LV) systolic dysfunction.Methods Forty-six patients with LV systolic dysfunction and 15 healthy controls were included in this study.Patients were sub-divided into three groups according to left ventricular ejection fraction(LVEF) derived from Simpson method:15 patients with minute systolic dysfunction(Group I) were with LVEF% of 40%～50%;14 patients with moderate systolic dysfunction(GroupⅡ) were with LVEF% of 30～39%;and 17 patients with severe systolic dysfunction(Group Ⅲ) were with LVEF% of 20～29%.Using transthoracic echocardiography,E and A peak wave velocities of mitral valve,the ratio of E to A(E/A),the A peak wave velocity of pulmonary vein(PV-A)were respectively measured and the ratio of pulmonary venous A to mitral A velocity(PV-A/A) was caculated.Results The LVEF was significantly lower in all patient groups than in normal controls and the lowest was in group Ⅲ(P<0.01).The mitral peak E wave velocity in group Ⅲ was higher than in group ⅠandⅡ(P<0.01,0.05,respectively).The mitral peak A wave velocity was significantly lower in group Ⅲ than in others(P<0.01,0.05) and the highest was in group Ⅰ.The E/A was higher in group Ⅲ than in others(P<0.01).The pulmonary A wave velocity(PV-A) did not differ among groups Ⅰ,Ⅲ and the controls,and was higher in group Ⅱ(P<0.01,0.05).The PV-A/A ratio was significantly higher in group Ⅲ than in others(P<0.01,0.05).Conclusions An increased ratio of PV-A/A were noted in subjects with LV systolic dysfunction.This supports the idea that the PV-A/A ratio reflects LV filling pressures,and may be more accurately to assess subjects with LV systolic dysfunction.

关 键 词：超声检查 左心功能障碍 

分 类 号：R541.6[医药卫生—心血管疾病] R445.1[医药卫生—内科学]