单纯主动脉瓣反流对椎动脉血流频谱影响的分析  

Analysis of the effects of pure aortic regurgitation on the vertebral artery blood flow spectrum

作　　者：景红霞 祝瑜 葛全虎 郑光美 肖彬 许涛 JING Hong-xia;ZHU Yu;GE Quan-hu;ZHENG Guang-mei;XIAO Bin;XU Tao(Department of Ultrasound,Shiyan People′s Hospital Affiliated to Hubei University of Medicine,Shiyan Hubei 442000,China)

机构地区：[1]湖北省十堰市人民医院(湖北医药学院附属人民医院)超声科,442000

出　　处：《蚌埠医学院学报》2020年第3期381-383,387,共4页Journal of Bengbu Medical College

基　　金：湖北省卫生健康科研基金资助项目(WJ2019F046);湖北省十堰市引导性科研项目(19Y58)。

摘　　要：目的:探讨单纯主动脉瓣反流对椎动脉血流频谱的影响。方法:选择2015年1月至2018年4月63例主动脉瓣反流病人作为观察组,其中,轻、中、重度主动脉瓣关闭不全(AR)组各21例;同期选取21例作为对照组,经胸超声心动图及颈椎动脉超声检查均无明显异常。分别记录观察组和对照组双侧椎动脉频谱曲线,观察频谱形态,分析血流动力学参数,包括收缩期最大流速(PSV)、舒张期末血流速度(EDV)、阻力指数(RI)。结果:两峰相近或相等的收缩期重搏波可在轻、中、重度AR组中出现,出现率分别为24%、62%、81%;中度AR组有5例舒张期血流达基线,3例反向,重度AR组有4例达基线,11例反向;收缩期重搏波与舒张期血流达基线或舒张期血流反向同时出现14例;与对照组相比,轻度AR组椎动脉PSV、EDV、RI差异均无统计学意义(P>0.05);观察组EDV随着主动脉瓣反流程度的增加而降低(P<0.01),而RI随着主动脉瓣反流程度的增加而升高(P<0.01)。结论:收缩期重搏波可出现在主动脉瓣轻、中、重度反流病人中,舒张期血流达基线或反向仅在中度和重度主动脉瓣反流中出现。当椎动脉出现上述血流频谱改变时高度怀疑AR。Objective:To investigate the effects of pure aortic regurgitation on the vertebral artery blood flow spectrum.Methods:Sixty-three patients with aortic regurgitation from January 2014 to April 2017 were set as the observation group,and subdivided into the mild,moderate and severe aortic insufficiency(AR)(21 cases in each group).Twenty-one cases with normal transthoracic echocardiography and cervical artery ultrasound were set as the control group.The bilateral vertebral artery spectrum curves and spectrum morphology in two gorups were observed,and the hemodynamic parameters(including PSV,EDV and RI)in two groups were analyzed.Results:The systolic heavy wave with similar or equal peaks appeared in the mild,moderate and severe AR groups,the occurrence rates of which were 24%,62%and 81%,respectively.Five cases with diastolic blood flow reaching baseline and 3 cases with reverse in moderate AR group,and 4 cases with diastolic blood flow reaching baseline and 11 cases with reverse in severe AR group were identified.Fourteen cases with systolic heavy wave complicated with diastolic blood reaching baseline or diastolic blood flow reverse were found.The differences of the PSV,EDU and RI of vertebral artery were not statistically significant between the control group and mild AR group(P>0.05).In observation group,the EDV decreased,and RI increased with the increase of AR(P<0.01).Conclusions:The systolic heavy wave can occur in patients with mild,moderate and severe AR,and the diastolic blood flow reaching baseline or reverse only occurs in moderate and severe AR.AR is highly suspected when the vertebral artery presents the above changes in the blood flow spectrum.

关 键 词：主动脉瓣关闭不全 椎动脉 多普勒频谱 

分 类 号：R542.5[医药卫生—心血管疾病]