中老年Lutembacher综合征彩色多普勒超声心动图特征研究  

Study on Characteristics of Lutembacher＇s Syndrome on the Middle-ager and the Aged Patients by Color Doppler Echocardiography

作　　者：侯传举[1] 邓东安[1] 朱鲜阳[1] 韩秀敏[1] 刘剑立[1] 胡斌 王巧玲[1] 

机构地区：[1]沈阳军区总医院,沈阳市110016 [2]武警大连医院

出　　处：《中国超声医学杂志》2009年第5期515-518,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探寻中老年Lutembacher综合征（LS）彩色多普勒超声心动图（CDE）特征。方法应用CDE检查20例中老年LS,寻找CDE特征改变,15例心导管资料对照,6例内科行介入治疗,7例经外科手术证实。结果根据CDE特征表现对所有病例全部做出正确诊断。LS的CDE特征明显：（1）M型超声心动图显示二尖瓣曲线呈“城垛样”改变,称M型超声心动图“城垛征”。（2）二维超声心动图（2DE）胸骨旁左室长轴切面显示左心房和右心室内径增大,二尖瓣开放受限,二尖瓣呈“壶嘴样”改变,称2DE“壶嘴征”。胸骨旁二尖瓣水平心室短轴切面显示二尖瓣开放受限,二尖瓣呈“鱼口样”改变,称2DE“鱼口征”。心尖四腔心切面显示左心房、右心房和右心室内径增大,房间隔不同大小回声中断。胸骨旁大动脉短轴切面显示2条大动脉位置关系正常,肺动脉内径明显大于主动脉内径;肺动脉瓣开放时间缩短,关闭时间延长。（3）连续多普勒估测肺动脉压力所有患者均〉50 mm Hg（1 mm Hg=0.133 kPa）。（4）彩色多普勒血流显像显示过房间隔左向右五彩镶嵌分流束血流信号;过二尖瓣五彩镶嵌射流束血流信号和反流束血流信号;过三尖瓣和肺动脉瓣五彩镶嵌反流束血流信号。（5）中老年LS女性明显多于男性。结论中老年LS的CDE特征明显,CDE对中老年LS有特异性诊断价值。Objective To probe into the imaging characteristics of Lutembacher＇s syndrome （LS） in patients over 40 years old by color Doppler echocardiography （CDE）. Methods Twenty patients of LS were examined by CDE. 15 cases underwent cardiac catheterization contrast. 6 cases interventional therapy. 7 cases were confirmed by operation. Results All cases were accurately diagnosed by imaging character of CDE. The CDE characteristics of LS were obvious： （1） M-mode echocardiographic assessment of the bicuspid valve looks like ＂ city wall＂, so it is named, ＂ city wall＂ sign of M-mode echocardiography. （2） Parasternallong-axis view of two-dimensional echocardiography （2DE） at the level of left ventricle showed enlarged left atrium and right ventricle and reduced the opening of the mitral valve which looks like ＂ tea spout＂, so we named it, ＂ tea spout＂ sign of 2DE. Parasternal short-axis view of ventricle at the level of bicuspid valve showed reduced opening of the bicuspid valve looks like＂ fish mouth＂, so we named it,＂ fish mouth＂ sign of 2DE. Apical four chamber view showed enlarged left atrium, right atrium and right ventricle and varying size of echo dropout in the interatrial septum. Parasternal short-axis view showed normal relationship of the two great arteries. The minor diameter of the pulmonary artery was significantly longer than the aorta with shortened opening and prolonged closure of the pulmonary valve. （3） Pulmonary artery pressure was over 50 mm Hg in all patient5 assessed by continuous-wave Doppler. （4） Color Doppler flow imaging showed colorful shunt flow signals through interatrial septum, colorful jet flow and reflux signals through bicuspid valve, and colorful reflux signals through tricuspid valve and pulmonary valve. （5） The incidence rate of LS was much higher in female than in male. Conclusions The CDE imaging characteristics of LS are obvious and CDE has specific diagnostic value for LS.

关 键 词：先天性心脏病 LUTEMBACHER综合征 彩色多普勒超声心动图 

分 类 号：R541.105[医药卫生—心血管疾病] R541.1[医药卫生—内科学]