不同程度肺动脉收缩压对冠状静脉窦构型及血流动力学的影响  

Changes of the Coronary Sinus Configuration and Hemodynamic Parameters with Varying Pulmonary Artery Systolic Pressure

作　　者：许建萍[1] 陈武[1] 郝美芳[1] 王慧英[1] 

机构地区：[1]山西医科大学第一医院,太原030001

出　　处：《中西医结合心脑血管病杂志》2015年第13期1517-1520,共4页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：山西省卫生厅基金资助项目(No.201201066)

摘　　要：目的使用超声心动图研究不同程度肺动脉收缩压时,冠状静脉窦构型及血流动力学参数的变化特点。方法应用经胸超声心动图对病例组及对照组冠状静脉窦进行探测,在M型超声心动图上测量其收缩末期最大内径(CSSD)、舒张早期内径(CSDD)、心房收缩期内径(CSAD);使用频谱多普勒超声测量收缩期最大流速(CSSVmax)、舒张早期最大流速(CSDVmax)、心房收缩期最大流速(CSAVmax)、速度时间积分(VTIS、VTID、VTIA);使用xPlane多平面成像技术获得与M型超声相同取样线上冠状静脉窦短轴图像,使用轨迹法测量与M型超声相同时相时冠状静脉窦面积xCSSA、xCSDA、xCSAA,计算x每搏回心血量及每分回心血流量(xQnet);对各项指标进行统计学分析。结果冠状静脉窦内径及横截面积与对照组比较,病例组1冠状静脉窦内径及横截面积增加,但无统计学意义,病例组2、病例组3冠状静脉窦内径及横截面积显著增大(P<0.05)。与对照组比较,各病例组的CSSVmax、CSDVmax均显著下降(P<0.05);与对照组比较,病例组1、病例组2 CSAVmax无显著变化,病例组3 CSAVmax明显升高(P<0.05)。与对照组比较,各病例组的VTIS及病例组2、病例组3 VTID明显减小(P<0.05),病例组2、病例组3 VTIA逐渐增加(P<0.05)。结论随着肺动脉收缩压不断增加,冠状静脉窦发生内径增宽、横截面积增大、正向血液回流速度减慢等重构性、适应性改变。Objective To research the changes of the coronary sinus（CS）configuration and hemodynamic parameters in patients with varying pulmonary artery systolic pressure.Methods the The coronary sinus in both the case group and the control group were sur-veyed by transthoracic echocardiography.Systolic internal diameter （CSSD）,early diastolic internal diameter （CSDD）,atrial systolic internal diameter （CSAD）of the coronary sinus were measured by M mode echocardiography.The systolic peak flow velocity （CSS-Vmax）,early diastolic peak flow velocity （CSDVmax）,peak flow velocity at atrial contraction （CSAVmax）,and respective flow veloci-ty time integral （VTIS,VTID,VTIA）by PW were measured.Obtaining short axis images of the coronary sinus with the same sampling line as M mode echocardiography by xPlane multi planar imaging techniques,the coronary sinus area with the same phase as the M mode ultrasound （xCSSA,xCSDA,xCSAA）through drawing the trajectory of the coronary sinus were calculated.Then the net blood flow volume once and perminute （xQnet）were computed.Statistical analysis was performed on the indicators.Results Com-pared with control group,the coronary sinus diameter and cross sectional area increased significantly in case group 2 and case group 3 （P〈0.05）.The CSSVmax and CSDVmax decreased significantly in al case groups（P〈0.05）.The CSAVmax increased significantly in case group 3（P〈0.05）.VTIS in al case groups and VTID in case group 2 and case group 3 reduced significantly（P〈0.05）.VTIA increased gradual y in case group 2 and 3（P〈0.05）.There was no significant difference in the net blood flow volume once and perminute between case groups and control group.Conclusion With increasing of pulmonary artery systolic pressure,the changes of reconfigurability and adaptability in coronary sinus occured,which included the heighten of diameter and cross sectional area,and the reduction of forward flow velocity.

关 键 词：肺动脉高压 冠状静脉窦 构型 血流动力学 

分 类 号：R544.1[医药卫生—心血管疾病]