多普勒超声心动图估测二尖瓣口充盈能量和能量效率  

Assessment for Mitral Valvular Filling Energy and Energy Efficiency by Doppler Echocardiography

作　　者：赵文强[1] 蔡妙贞[1] 曹润萧[1] 杜微云[1] 

机构地区：[1]广州市第一人民医院

出　　处：《中国循环杂志》1999年第2期99-101,共3页Chinese Circulation Journal

摘　　要：目的：研究二尖瓣口充盈能量和能量效率与瓣口工作效率之间的关系。方法：应用多普勒超声心动图对３种状态即自然瓣、狭窄瓣和机械瓣〔共分为５组即正常组、狭窄瓣组、二尖瓣替换术（ＭＶＲ）后２周组、ＭＶＲ后１．０～４．９年组和ＭＶＲ后５～１０年组〕的二尖瓣口及不同瓣号、瓣型和瓣龄的机械瓣口能量学指标与瓣口功能的定量关系作对比研究。结果：狭窄瓣组较正常组有效充盈能（Ｅｅｆ）和总充盈能（Ｅｔｏｔ）显著增加，能量效率（η）显著降低；ＭＶＲ后２周、１．０～４．９年、５～１０年组较狭窄瓣组Ｅｅｆ和Ｅｔｏｔ显著降低，而η显著增加；η随瓣口狭窄级别和替换瓣龄的增大而进行性下降；机械瓣同号不同瓣型（单叶与双叶）之间η有显著差异，时间－η曲线分离。η与瓣口面积、瓣口阻力和左心房张力成较好的相关关系（分别为ｒ＝０．６７，ｒ＝－０．７２，ｒ＝－０．８２）。结论：瓣口能量效率是衡量不同状态和不同机械瓣龄的二尖瓣口能量分配、利用及工作效率优劣的重要标准。Objective:To study the association between mitral valvular filling energy and energy efficiency under different conditions and valvular work efficiency. Methods:Filling energy indexes and valvular function indexes in three kinds of condition of mitral valves including the natural,the stenotic and the mechanical valves and different valve numbers,valve types and valve ages of mechanical valves in mitral position were comparatively studied by Doppler Echocardiography. Results:Significant increased effective filling energy(Eeff)and total filling energy (Etot) and significant decreased energy efficiency (η)were found in the stenotic versus the natural and inverse changes found in the mechanical (post mitral valve replacement)versus the stenotic (pre MVR).η was progressive decreasing as valvular stenosis classification and valve ages of mechanical valves increasing.η were significant difference between different valve leaf types (sigle leaf and double leaf )of same mechanical valve numbers,their time η curves were divided between different types of mechanical valves.η had a better correlation with mitral valve area (MVA),mean valvular resistance(MR)and left atrial tension (LAT)( r =0 67, r =-0 72, r =-0 82,respectively). Conclusion:η is an important index for evaluation of energy distribution and usage and work efficiency of mitral filling under different conditions of mitral valves and different valve ages of mechanical valves.

关 键 词：二尖瓣狭窄 能量效率 超声心动图 二尖瓣口 

分 类 号：R542.510.4[医药卫生—心血管疾病] R540.45[医药卫生—内科学]