双平面经食管彩色多普勒评价二尖瓣返流对肺静脉血流的影响  

Evaluation of Effect of Mitral Regurgitation on Pulmonary Venous Flow Using Biplane Transesophageal Color Doppler Echocardiography

作　　者：游又庭[1] 蓝玉福[1] 陈良龙[1] 李金国[1] 林丽珍[1] 张平洋 

机构地区：[1]福建医学院附属协和医院心血管研究中心

出　　处：《中国医学影像技术》1996年第6期407-409,共3页Chinese Journal of Medical Imaging Technology

摘　　要：本文应用双平面经食管多普勒测定了２０例正常人和３８例二尖瓣返流（ＭＲ）患者的肺静脉血流频谱，旨在评价不同程度ＭＲ对肺静脉（ＰＶ）回流的影响。结果表明：①与正常组相比，明显ＭＲ组ＰＶ收缩期峰值流速及流速积分显著降低（Ｐ＜０．０２），而舒张期峰值流速及流速积分显著升高（Ｐ＜０．０５及０．０２），且随着ＭＲ程度的加重，上述改变更趋明显；②３８例ＭＲ患者中，２４例记录到ＰＶ收缩期负向波，其中轻度ＭＲ４例（３３．３％），中度ＭＲ７例（７０％），重度ＭＲ１３例（８１．２％），房颤及窦性心律的ＭＲ患者出现ＰＶ负向波的例数无明显差异（１２／１９对１０／１９，Ｐ＝０．３７）；③ＭＲ时，ＰＶ收缩期负向波流速与ＭＲ返流束面积和长度正相关（ｒ分别为０．５１及０．４１，Ｐ＝０．００１和０．０１４），而与ＭＲ最大返流速度及返流压差不相关（Ｐ＞０．０５）。结论：ＭＲ对肺静脉血流具有重要影响，主要是使肺静脉在收缩期的回流减慢甚至出现倒流，后者尤常见于重度ＭＲ者。In order to evaluate the effect of gradual mitral regurgitaion (MR) on pulmonary venous flow (PV), 20 normal subjects and 38 patients with MR were investigated using biplane transesophageal color Doppler echocardiography. The results showed that, in patients with remarkable MR, the peak systolic velocity and systolic velocity integral decreased (P<0. 02), whereas the peak diastolic velocity and dialostic velocity integral increased (P<0. 05 and 0. 02) significantly, compared to normal subjects. These changes became more marked as the degree of MR increased. Among those with MR,systolic reversed flow wave was found in 24 patients, of which 4 in mild (33. 3%), 7 in moderate (70%), and 13 in severe MR(81. 3%). There was no significant difference in number of systolic reversed waves between patients with atrial fibrilation and sinus rhythm (12/19 versus 10/19, p=0.37). The peak systolic reversed flow velocity was positively correlated to the area and length of regurgitant jet (r=0. 51, p = 0. 001 and r=0. 41, p = 0. 014, respectively), and not correlated to peak velocity and pressure gradient of regurgitation (P>0. 05). It was concluded that MR had important effect on PVF, mainly decreased the systolic pulmonary venous drainage or even made it become retragrade.This systolic reversed flow was seen more often in those with severe MR. So it was helpeful to evaluate the severity of MR by investigating PVF spectrum.

关 键 词：二尖瓣返流 肺静脉血流 彩色多普勒 超声波诊断 

分 类 号：R542.510.4[医药卫生—心血管疾病]