影响二尖瓣关闭不全听诊的相关因素  

Factors affecting auscultation in diagnosis of mitral regurgitation

作　　者：吴林根[1] 陈敏[1] 吴旸[2] 

机构地区：[1]第二军医大学利群临床医学院利群医院物理诊断科,上海200333 [2]上海市普陀区中心医院超声波室,上海200062

出　　处：《心脏杂志》2007年第2期176-178,共3页Chinese Heart Journal

摘　　要：目的探讨左房室内径、左室射血分数(LVEF)返流速度、返流方向等超声参数对二尖瓣返流听诊诊断的可能影响。方法随机选择151例经超声心动图检查,显示有中度及中度以上二尖瓣返流的患者,根据彩色多普勒血流显像分别测定LVEF、返流速度等超声参数,比较其在杂音组及无杂音组间统计学差异,分析其对听诊的可能影响。结果LVEF、最大返流速度、最大返流压差、左房内径、胸壁厚度等在杂音及无杂音组间有显著性差异(P<0.01);返流束偏心及居中的两组间有显著性差异(P<0.01);返流束贴壁与不贴壁返流间差异显著(P<0.01)。结论心功能低下、返流速度缓慢、胸壁厚、血流方向居中者不易闻及二尖瓣收缩期返流性杂音。AIM To explore the possible influence of ultrasonic parameters on cardiacauscultation in the diagnosis of mitral regurgitation. METHODS Left ventricular ejective fraction （ LVEF）, regurgitant velocity and regurgitant direction were examined by color Doppler echocardiography in 151 patients with medium mitral regurgitation. The results of LVEF, regurgitant velocity and regurgitanting gradient were compared between patients with and without murmur grope. RESULTS LVEF, max regurgitating velocity, max regurgitating gradient, LAd, thickness of chest wall produced significant differences in the audibility of cardiac murmur between patients with and without murmur （ P 〈 0.01 ）. Significant differences were found in the audibility of cardiac murmur between central regurgitant color flow jets and eccentric regurgitant color flow jets（ P 〈 0.01 ）between regurgitant color flow jets along atrial wall and not along atrial wall. CONCLUSION Cardiac murmur can be easily heard in the patients with normal cardiac function, fast regurgitant velocity, thin chest wall and excursive regurgitation jets.

关 键 词：二尖瓣返流 收缩期杂音 彩色多普勒 血流显像 射血分数 听诊 

分 类 号：E540.4[军事—军事理论]