二尖瓣机械瓣下游流场均匀性多普勒超声研究  

Study on the flow field uniformity downstream of mitral mechanical disc by doppler echocardiography

作　　者：张桂敏[1] 李守先[2] 顾华美[2] 张运[2] 张微[2] 钟敬泉[2] 

机构地区：[1]昆明医学院第一附属医院,云南昆明650032 [2]山东大学齐鲁医院

出　　处：《山东医药》2005年第6期4-6,共3页Shandong Medical Journal

基　　金：国家博士后科学基金资助项目

摘　　要：目的　建立二尖瓣机械瓣下游流场均匀性无创超声检测方法 ,评估保留瓣下结构对不同类型机械瓣下游血流动力学性能的影响。方法　采用彩超实时检测保留瓣下结构的不同类型机械瓣置换术后患者二尖瓣下游流场均匀性与常规血流动力学参数并对比研究。结果　无论保留全瓣或后瓣瓣下结构 ,双叶机械瓣 (双叶瓣 )下游流场均匀性测值均低于单叶机械瓣 (单叶瓣 ) (P<0 .0 5 ) ;对于双叶瓣 ,保留全瓣组流场均匀性测值均高于另两组 (P<0 .0 5 ) ;对于单叶瓣 ,流场均匀性测值在未保留组最低 ,保留后瓣组次之 ,保留全瓣组最高 (P<0 .0 5 )。流场均匀性指标与常规多普勒超声指标间有明显相关性。结论　多普勒超声可用于机械瓣血流动力学性能的评估。保留瓣下结构一定程度上增加跨瓣血流的扰动性 ,使机械瓣下游流场均匀性变差 ,以保留全瓣者为著 ,单叶瓣甚于双叶瓣。Objective To established the non-invasive method of measuring the flow field uniformity downstream of mitral mechanical disc by Doppler echocardiography for evaluating the effect of preservation of subvalvular apparatus on the hemodynamics downstream of the different kinds of mechanical heart disc.Method Using color Doppler echocardiography measured and analyzed the data about the flow field uniformity and the hemodynamics downstream of the different kinds of mechanical disc in the patients having undergone mitral valve replacement with preservation of subvalvular apparatus.Results Both for the total and the partial preservation of subvalvular apparatus,the measured data of flow field uniformity downstream of bileaflet disc were less than that downstream of monoleaflet disc(P<0.05).As to bileaflet disc,the measured data of flow field uniformity in the group with the total preservation of subvalvular apparatus were more than that in the other two groups(P<0.05). And as to monoleaflet disc, the measured data of flow field uniformity were the lowest in the group without preservation,were the highest in the group with total preservation and were moderate in the group with partial preservation(P<0.05).Besides,there was a obvious relationship between the items of flow field uniformity and the routine ones of Doppler echocardiography.Conclusions The method by which the flow field uniformity downstream of mitral mechanical disc is measured can obstructively describe the flow field uniformity in human being.It can be used to evaluate the hemodynamic function of mechanical heart valve.The preservation of subvalvular apparatus,to some extent will increase the turbulence of transmitral flow and will make the flow field uniformity poorer.The bad effect is particularly great for the total preservation and it is greater in monoleaflet disc than in bileaflet one.

关 键 词：二尖瓣 瓣下结构 流场均匀性 多普勒超声 机械瓣置换术 

分 类 号：R654.2[医药卫生—外科学] R445.1[医药卫生—临床医学]