门静脉搏动比与心功能变化的相关性分析研究  

Study of relationship between portal vein pulsatility ratio and changes of cardiac function in patients with congestive heart failure

作　　者：童晓明[1] 辛国芳[1] 邱菊[1] 周荣清[1] 张俊华 

机构地区：[1]山东省淄博市中心医院,山东淄博255036 [2]张店钢铁厂职工医院,山东淄博255026

出　　处：《中国临床医学影像杂志》2000年第2期106-108,共3页Journal of China Clinic Medical Imaging

摘　　要：目的 :应用超声技术评价门静脉搏动比与心功能变化的关系。方法 :研究组由58例心力衰竭患者组成 ,年龄38～72(平均55.6±11.8)岁 ,应用心脏和腹部超声技术测定病人的心脏和门静脉及肝静脉血流动力学指标。结果 :28例严重的左心衰竭(Ⅲ～Ⅳ级)患者与30例轻度心力衰竭(Ⅰ～Ⅱ级)病人比较 ,左房室扩大收缩功能显著性降低(P<0.001) ;肝静脉内径增加而门静脉搏动比(PVPR)降低(P<0.001)。所有病人的PVPR与左室缩短分数(SF)及射血分数(EF)呈线性正相关(r为0.56及0.60) ,PVPR与肝静脉直径(HVD)、左室内径(LVD)、左室舒张末容积(LVEDV)、左室收缩末容积(LVESV)、左房内径(LAD)、左房容积(LAV)及左房压力(LAP)呈线性负相关关系(相关系数r依次为 -0.69、 -0.66、 -0.61、-0.64、 -0.60、 -0.58、 -0.56)。结论 :随着心力衰竭的进行性加重 ,门静脉血流动力学发生严重变化 ,因而测定门静脉的搏动类型比测定腔静脉和肝静脉的形态学变化更能反映心力衰竭的状态 ,PVPR可作为评价心力衰竭的一个可靠的辅助指标。Objective:To investigate the relationship between POrtal portal vein pulsatility ratio (PVPR) and changes of cardiac function by ultrasound technique. Methods: The study group consist of 58 patients with congestive heart failure. The mean age 55.6±11.8 years. PVPR and left atrium ventricle function as well as the changes of hemodynamics indexes were measured by two dimensional Doppler echocardiography and duplex Doppler sonography. Results: 28 patients with more severe left ventricular failure (NYHA class Ⅲ～Ⅳ) showed more dilatation of the left atrium and ventricle, reduced systolic function,reduced portal vein mean velocity,increased hepatic vein diameter and reduced PVPR compared with 30 patients with milder heart failure (NYHA class Ⅰ～Ⅱ).Considering all patients, significant positive correlations were found between PVPR and left ventricular shortening fraction (SF,r=0.66,p<0.01)and ejection fraction (EF,r=0.60,p<0.001). Significant negative correlations were found between PVPR and hepatic vein diameter (HVD),left ventricular diameter (LVD),left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV),left atrial diameters (LAD),left atrial volume (LAV) and left atrial pressure (LAP); the correlation coefficients r were -0.69,-0.66,-0.61,-0.64,-0.60,-0.58,-0.56 (p<0.01 or p<0.001)respectively.Conclusion: The effects of cardiac failure on portal vein hemodynamics, which declines progressively with worsening cardiac function,is shown better by the pulsatility pattern of the portal vein than by morphologic caval and hepatic vein measurements.PVPR can be used as a reliable adjunctive index of heart failure.

关 键 词：充血笥心力衰竭 门静脉博动比 超声心动图 

分 类 号：R541.61[医药卫生—心血管疾病]