双平面经食管超声观察肺静脉血流估测肺毛细血管楔嵌压  

Estimation of Mean Pulmonary Capillary Wedge Pressure from Transesophageal Pulsed Echocardiography of Pulmonary Venous Flow

作　　者：张平洋[1,2,3] 蓝玉福[1,2,3] 游又庭[1,2,3] 陈良龙[1,2,3] 翁钦永[1,2,3] 林朝[1,2,3] 李金国 林丽珍 

机构地区：[1]安徽皖南医学院附属弋矶山医院心血管彩超室 [2]福建医科大学附属协和医院心血管中心 [3]福建医科大学附属协和医院心血管中心心外手术室

出　　处：《中华超声影像学杂志》1998年第3期149-152,共4页Chinese Journal of Ultrasonography

摘　　要：应用双平面经食管超声观察肺静脉血流（ＰＶＦ）估测肺毛细血管楔嵌压，共研究了２０例风湿性心脏病人的肺静脉血流特征，并与心导管检查测得的平均肺毛细血管楔嵌压（ＭＰＣＷＰ）进行相关比较分析。结果：风心病以二尖瓣狭窄为主要病变患者的ＰＶＦ参数中，收缩分数（ＳＦ）与ＭＰＣＷＰ相关性最好（ＭＰＣＷＰ＝３４．０８－０．４０×ＳＦ，ＳＥＥ＝２．８９ｍｍＨｇ，ｒ＝－０．８８，Ｐ值＜０．０１），且多元逐步回归表明：二尖瓣环下降（ＤＯＢ）、左房舒张率（ＥＩ）、左室短轴缩短率（ＦＳ）及血压（ＳＢＰ、ＤＢＰ）、心率（ＨＲ）、年龄（Ａｇｅ）等因素均不明显影响之。结论：ＳＦ是估测风心病二窄为主要病变患者ＭＰＣＷＰ的较好指标。To determine whether variables of pulmonary venous flow (PVF) measured by transesophageal echocardiography could be used to estimate mean capillary wedge pressure(MPCWP). Methods: Twenty consecutive patietns with almost pure rheumatic mitral valve stenosis were prospectively examined and the Doppler variables of PVF were correlated with MPCWP measured by cardiaccatheterization. Results: Among the variables of PVF in patients with almost pure rheumatic mitrial valve stenosis, the systolic fraction (SF) (i.e.,the systolic velocitytime integral expressed as a fraction of the sum of systolic and diastolic velocitytime integrals) correlated best with MPCWP (MPCWP=34.08-0.40×SF, SEE=2.89mmHg, r=-0.88,P<0.01). A multiple stepwise linear regression analysis showed that descent of mitral anulus, left atrial expansion, ventricule constraction, SBP, DBP,HR and Age did not significently influence this relationship. Conclusion: SF was better variable which could estimate MPCWP in patients with almost pure rheumatic mitral valve stenosis. This method offer a simple and reliable approach to noninvasive estimation of MPCWP.

关 键 词：经食管 超声描记术 肺静脉血流 肺楔压 

分 类 号：R540.4[医药卫生—心血管疾病] R445.1[医药卫生—内科学]