心脏瓣膜置换术前后对多普勒Tei指数影响的研究  

To evaluate the effects of valve dysfunction on Doppler Tei index before and after surgical valve replacement

作　　者：张秀珍[1] 宋少杰[1] 梁绪国[1] 姜进军[1] 高鲁生[1] 

机构地区：[1]青岛大学医学院附属烟台毓璜顶医院超声科,山东省264000

出　　处：《中国超声诊断杂志》2005年第11期807-809,共3页Chinese Journal of Ultrasound Diagnosis

摘　　要：目的本研究应用彩色多普勒超声技术,对二尖瓣及主动脉瓣置换术前后Tei指数进行检测,旨在观察心脏瓣膜置换术前后Tei指数的变化,评价瓣膜功能不全对Tei指数的影响。方法选取86例进行主动脉瓣或二尖瓣置换术的患者〔其中21例主动脉瓣狭窄(AS),17例主动脉瓣关闭不全(AR),28例二尖瓣狭窄(MS),20例二尖瓣关闭不全(MR)〕。分别于术前1周至一个月、术后1周至1个月,应用经胸超声多普勒技术测量患者的左室射血分数(LVEF)、左室短轴缩短率(FS)、左室舒张末内径(LVDd)、左室收缩末内径(LVDs)、左房内径(LAD)及Tei指数。结果主动脉瓣狭窄、主动脉瓣关闭不全及二尖瓣狭窄患者术后Tei指数都有不同程度增加,差异均有显著性意义(P<0.01),二尖瓣关闭不全患者术后Tei指数反而降低,但差异无显著性意义(P>0.05)。其余测量指标手术前后也存在不同程度的差异。结论心脏瓣膜置换术后Tei指数有明显的变化,尤其在主动脉瓣狭窄患者。因此在评价瓣膜病患者的左心室功能时应考虑到瓣膜功能不全对Tei指数的影响。Objective This study of evaluating the effects of valve dysfunction on Tel index was designed to analyse Tel index recarded of before and after surgical valve replacement. Methods Participants consisted of 86 consecutive patients with aortic or mitral valve surgery [21patients with aortic stenosis （AS）, 17 with aortic regurgitation, 28 with mitral stenosis, and 20 with mitral regurgitation]. Left ventricular ejection fraction （LVEF）, fractional shortening （FS）, left ventrieular end-diastolic dimension （LVDd）, left ventrieular end-systolic dimension （LVDs）, left atrial dimension （LAD）, and Tel index were measured by transthoracic echocardiography in 1 week to 1 month before and after surgery. Doppler Tel index was also evaluated before and after the surgery according to the obtaining （a-b）/b, here ＂a＂ is the interval between the cessation and onset of Doppler mitral filling flow and ＂b＂ is the aortic flow ejection time. Results Tel index significantly increased after surgery in patients with aortic stenosis, aortic regurgitation, and mitral stenosis and the difference were significant （P〈0.01）. Tel index decreased in mitral regurgitation and no significant difference （P〉0.05）. There were statistical difference in all other measurements but not all the parameters were different and percentage change of Tel index after valve surgery was maximal in patients with As. Conclusions Tel index significantly changes after valve surgery especially in patients with As. So when you evaluate left ventrieular function in patients with valve disease, you should consider the effects of valve dysfunction on Tel index.

关 键 词：超声心动图技术 心脏瓣膜置换术 左心室功能Tei指数 心脏瓣膜置换术后 彩色多普勒超声技术 TEI指数 手术前后 影响的研究 主动脉瓣关闭不全 二尖瓣关闭不全 

分 类 号：R542.5[医药卫生—心血管疾病] R331.31[医药卫生—内科学]