彩色多普勒检测主动脉瓣病变患者颈动脉血流变化  

A Study of Changes in Carotid Artery Flow with Aortic Valve Diseases Detected by Color Doppler Ulrasound

作　　者：吴凤林[1,2] 张爱宏[1,2] 裘佩春 段学蕴[1,2] 

机构地区：[1]第一军医大学南方医院超声科 [2]西安医科大学第二附属医院医用超声研究室

出　　处：《中华超声影像学杂志》1998年第1期29-31,共3页Chinese Journal of Ultrasonography

摘　　要：为探讨主动脉瓣病变对颈动脉血流动力学变化的影响，对正常组４２例，观察组４７例：其中主动脉瓣关闭不全１３例，主动脉瓣狭窄伴关闭不全３３例，主动脉瓣狭窄１例，进行了彩色多普勒血流检测。正常颈总动脉频谱形态呈三峰形，收缩期两峰Ｖｓ１＞Ｖｓ２；舒张早期可有反向频谱，△Ｔ／Ｔ比值＜１／１０。主动脉瓣狭窄伴关闭不全时，颈总动脉收缩期可出现“Ｍ”形频谱，出现率为７２．２％；１例主动脉瓣狭窄，颈动脉频谱形态呈“圆顶状”状。主动脉瓣关闭不全时，颈总动脉出现“舒张期返流”频谱，即△Ｔ／Ｔ≥１／１０。“舒张期返流”频谱的出现与瓣膜返流程度有关：轻度返流，△Ｔ／Ｔ比值正常或＜１／４，中度返流，在１／４～１／２之间，△Ｔ／Ｔ≥１／２，均为重度返流。６例瓣膜置换术后，４全颈动脉频谱形态恢复正常，２例仍有“舒张期返流”频谱，其主动脉瓣中度关闭不全。结果表明：主动脉瓣狭窄伴关闭不全时，颈总动脉收缩期可出现特征性“Ｍ”形；主动脉瓣关闭不全舒张期可见“舒张期返流”频谱。“舒张期返流”频谱是区分轻与中重度瓣膜关闭不全的简便方法，也可大致区分中与重度关闭不全。比较换瓣前后，颈动脉异常频谱形态变化。The purpose of this paper was to explore the hemodynamic changes in carotid artery with aortic valve diseases. The contral group included 42 cases. The patent's group included 47 cases:13 cases with aortic regurgitation(AR), 33 cases with AR combined with aortic stenosis(AS), and 1 case with AS. The normal common carotid artery (CCA) Doppler waveforms showed three peaks, and two peaks in systole(VS1>VS2); there were perhaps reversal spectrum in early diastole(△T/T ratio <1/10). In the patients with AR combined with AS, the CCA Doppler waveforms could show two equal peaks in systole like the letter “M”, the incidence of Mshaped waveforms was 72.7%. The waveform of one case suffering from AS showed the crude “arcshaped” on irs top in systole. “Retrograde diastolic flow” (RDF)waveforms among the cases with AR could appear in CCA in diastole (△T/T ratio≥1/10). The △T/T ratio of RDF waveforms were related to the degree of AR: if AR was mild, △T/T ratio was normal or <1/4; if moderate, the ratio 1/4￣1/2; if severe, the ratio≥1/2. Aortic valve replacement were carried on upon six patients, 4 of whom of the waveforms recovered in CCA, but in 2 cases the RDF waveforms appeared because of moderate AR in the replaced aortic valves. The results suggested the specific Mshaped waveforms appeared in systole in the patients with AR combined with AS. The RDF waveforms appeared in diastole in the patients with AR. It was a simple method by which the mild AR, moderate and severe was determined, and also helpful to roughly detrmine the moderate AR from severe. It may be one of the method to indirectly evaluate the function of aortic artificial valve by comparing the changes of Doppler waveforms in CCA before and after the aortic valve replacement.

关 键 词：彩色多普勒 主动脉瓣病变 颈动脉血流 

分 类 号：R543.1[医药卫生—心血管疾病]