平静呼吸对左室充盈的影响及其机制的超声心动图研究  

Mechanism Study on Quiet Respiration Effects on Left Ventricular Filling via Doppler Echocardiography

作　　者：李颖[1] 曹铁生[1] 袁丽君[1] 段云友[1] 

机构地区：[1]解放军第四军医大学唐都医院超声诊断科,西安市710038

出　　处：《中国超声医学杂志》2006年第4期264-266,共3页Chinese Journal of Ultrasound in Medicine

基　　金：军队科研基金(No.01MA190)资助

摘　　要：目的研究平静呼吸对二尖瓣血流的影响及其规律,进而探讨呼吸对左室充盈的影响,进一步验证呼吸影响心功能机制新假说。方法20例健康志愿者,同步记录二尖瓣血流速度曲线、心电图和呼吸曲线。连续测量5个呼吸周期吸气相和呼气相血流速度及速度-时间积分(VTI),取平均值。分别计算吸气相和呼气相二尖瓣舒张早期E波与舒张晚期A波的血流速度比值以及VTI比值。结果二尖瓣舒张早期E波血流速度及VTI在吸气相低于呼气相(84.28cm/s±15.16cm/s,92.45cm/s±15.96cm/s,P<0.0001;16.27cm±3.70cm,17.73cm±3.91cm,P<0.0001);舒张晚期A波血流速度及VTI在吸气相低于呼气相(51.61cm/s±9.86cm/s,54.21cm/s±11.27cm/s,P<0.0001;9.86cm±1.55cm,10.48cm±2.00cm,P<0.0001);E波与A波的血流速度比值及VTI比值在吸气相低于呼气相(1.69±0.47,1.78±0.52,P=0.001;1.68±0.43,1.75±0.47,P=0.003)。结论平静呼吸对二尖瓣血流影响具有规律性:E波血流速度及VTI、A波血流速度及VTI、E波与A波血流速度比值及VTI比值均在吸气相低于呼气相。在利用二尖瓣血流频谱评价左室充盈时如能结合呼吸变化,则能提供更多信息。进一步验证了呼吸影响心功能机制新假说。Objective To observe the effects of quiet respiration on transmitral Doppler flow and to verify the new hypothesis illustrating the mechanism of respiration effects on hemodynamics. Methods Pulsed-wave Doppler spectra of transmitral flow were recorded with Sequoia 512 in 20 normal subjects. Electrocardiogram and respiratory tracing were recorded synchronously. E and A waves of transmitral flow were measured and the velocity-time integrals （VTI） were calculated by the software. The transmitral flow velocity and VTI during inspiration and expiration were averaged for five continuous respiratory cycles respectively. The ratios of velocity and VTI of E to A of transmitral flow during inspiration and expiration were calculated respectively. Results The Doppler flow velocity and VTI of E wave were increased remarkably from inspiration to expiration （84.28±15.16 vs 92. 45±15.96 cm/s, P〈0. 000 1; 16. 27±3.70 vs 17. 73±3.91 cm,P〈0. 000 1）. The Doppler flow velocity and VTI of A wave were also increased remarkably from inspiration to expiration （51. 61±9.86 vs 54. 21±11.27 cm/s, P〈0. 000 1; 9. 86±1.55 vs 10. 48±2.00 cm, P〈0. 000 1 respectively）. The ratios of the velocity and VTI of E to A during inspiration were lower than those during expiration （1. 69±0. 47 vs 1. 78±0.52, P=0. 001; 1. 68±0.43 vs 1. 75±0. 47, P=0. 003, respectively） . Conclusions The effects of quiet respiration on transmitral Doppler flow were regular ： The velocities and VTI of E and A, the ratios of the velocity and VTI of E to A during inspiration were all lower than those during expiration. It would provide more informations in evaluating left ventricular filling. This study further proved the accuracy of the new hypothesis of respiration mechanism on hemodynamics.

关 键 词：平静呼吸 二尖瓣血流频谱 舒张功能 

分 类 号：R540.45[医药卫生—心血管疾病]