兔急性肺动脉高压的上腔静脉血流速度频谱分析  

Analysis of the spectra of superior vena cava in a rabbit model with acute thrombo-embolic pulmonary hypertension by echocardiography

作　　者：陈洪茂[1] 段云友[1] 周宁[1] 李娟[1] 杨玉辉[1] 曹铁生[1] 

机构地区：[1]第四军医大学唐都医院超声诊断科,西安710038

出　　处：《中华超声影像学杂志》2007年第8期718-721,共4页Chinese Journal of Ultrasonography

基　　金：全军医药卫生科研基金课题（06M275）

摘　　要：目的：探讨肺动脉血栓栓塞所致兔急性肺动脉高压上腔静脉血流速度频谱的特征及其意义。方法：建立肺动脉血栓栓塞所致兔急性肺动脉高压模型，经右锁骨上窝切面对肺栓塞前后的上腔静脉进行多普勒超声检测，并同步进行右心导管肺动脉压力测定。结果：健康新西兰兔30只，5只发生急性右心衰竭，25只成功建立急性肺动脉高压模型；二维超声显示上腔静脉内径与肺动脉收缩压呈显著正相关（r=0．594，P=0．002）；频谱多普勒显示上腔静脉血流频谱心室收缩期向心波（S）峰值速度与肺动脉收缩压呈显著负相关（r=-0．692，P=0．000）；心室收缩末期离心波（Vr）峰值速度于轻度肺动脉高压时明显增高，随肺动脉压力的升高逐渐降低，至重度时接近栓塞前水平（r=-0．292，P=0．157）；而Vr／S值与肺动脉收缩压呈显著正相关（r=0．698，P=0．000），较栓塞前显著增高（P＜0．05）。结论：急性肺动脉高压上腔静脉血流频谱S波峰值速度与肺动脉收缩压呈显著负相关，而Vr／S值与肺动脉收缩压呈显著正相关，可能对其早期诊断具有一定的临床意义。Objective To explore the characteristics and significance of the spectra of superior vena cana （SVC） in a rabbit model with acute thrombo-embolic pulmonary hypertension （ATEPH） by Doppler echocardiography. Methods Accompanied by measuring of the pulmonary artery systolic pressure （PASP） by right heart catheter, an examination of the spectra of SVC was simultaneously performed by Doppler echocardiography in the right supraclavicular fossa view before and/or after establishing of the rabbit models with ATEPH. Results Of 30 healthy New Zealand rabbits, 25 rabbit models with ATEPH were successfully established except 5 rabbits with acute right heart failure. The SVC diameter was positive relative with the PASP demonstrated by two-dimensional echocardiography （r = 0. 594, P = 0. 002 ）. The SVC flow spectral characteristics were showed as follows： the S wave peak velocity was negative relative with the PASP （r = -0. 692, P = 0. 000）; the Vr wave peak velocity accelerated apparently with mild pulmonary hypertension, then decelerated with the increase of the PASP to the normal level till severe pulmonary hypertension,and was negative relative with PASP（ r = - 0. 292, P = 0. 157） ; the Vr/S peak velocity ratio was positive relative with PASP（ r = 0. 698, P = 0. 000）, and significantly higher than the normal level（ P 〈 0. 05）. Conclusions The S wave peak velocity of the SVC spectra of ATEPH was significantly negative with the PASP and the Vr/S peak velocity ratio was significantly positive, which maybe play an important role in the diagnosis of acute pulmonary hypertension.

关 键 词：超声检查 高血压 肺性 腔静脉 上 肺栓塞 兔 

分 类 号：R686[医药卫生—骨科学]