风湿性二尖瓣狭窄患者心室功能与肺动脉压力相关性的超声研究  

The correlation study between ventricular function and pulmonary artery pressure in rheumatic mitral stenosis patients by ultrasound

作　　者：陈新颜[1] 高长征[1] 陈风[1] 高秀玲[1] 

机构地区：[1]苏州大学附属第四医院心血管内科,江苏省无锡市214062

出　　处：《临床超声医学杂志》2008年第11期748-750,共3页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨风湿性二尖瓣狭窄(MS)患者的左、右心室功能与肺动脉压力的关系。方法测量30例MS患者和25例健康者为对照组的超声心动图指标,运用脉冲型组织多普勒技术(PW-TDI)测算左心室二尖瓣环四个位点(后间隔、侧壁、前壁、下壁)的Tei值及其均值(t-Tei),三尖瓣环右室游离壁处的Tei值,根据三尖瓣反流估测肺动脉压力(PAP),并对各组值对比分析。结果①MS患者二尖瓣口面积(1.52±0.37)cm2,肺动脉收缩压(45±18)mmHg;与对照组比较,MS患者右心室Tei值、左心室各壁Tei值及t-Tei明显增大(P<0.001);②MS患者PAP与二尖瓣口平均跨瓣压差、左心室的Tei值呈正相关,与瓣口面积、左心房内径无相关性;③MS患者PAP与右心室Tei值呈正相关。结论MS患者左心室整体功能异常是MS患者PAP的重要影响因素,肺动脉高压影响右心室功能。Objective To explore the relationship between left and fight ventricular function and pulmonary artery pressure （PAP）in rheumatic mitral stenosis（MS） patients. Methods The routine echeeardiogram index of thirty patients with Ms and 25 contrast subjects were measured, mitral annulus of interventricular septum,lateral,inferior, anterior wall of left ventricular were measured by PW- TDI, tricuspid annulus of right ventricle free wall from apical four and two - chamberview were measured by tissue Doppler imaging （TDI） .Then Tei index and t - Tei index were calculated for both left and right ventricular.The PAP was derived from the tricuspid jet velocity. The correlation of PAP with mitral valve area（ MVA ）, mean mitral gradient, left atrial diameter, ejection fraction（EF）, and left and right ventricular Tei index were evaluated. Result MVA and PAP were measured as （1.52±0.37）cm^2 and （45±18）mmHg respectively. The TDI - derived Tei index of left and right ventricular in MS group was significantly different compared with the contrast group （ P 〈 0.001 ）. There was positive correlation between PAP and mean mitral gradient, left ventrieular Tei index, there was no significant correlation between MVA and left atrial diameter. There was positive correlation between PAP and right ventricular Tei index. Conclusion The left ventricular abnormal function of MS patients is an important effect factor of PAP,and PAH could effect right ventricular function.

关 键 词：二尖瓣狭窄 心室功能 组织多普勒成像 TEI指数 肺动脉压力 

分 类 号：R654.2[医药卫生—外科学] R540.45[医药卫生—临床医学]