二尖瓣狭窄患者肺静脉血流与左心房压力关系的研究  

The relationship between pulmonary venous flow and left atrial pressure in mitral stenosis

作　　者：朱慧[1] 张薇[1] 郝恩魁[1] 李继福[1] 张运[1] 

机构地区：[1]山东大学齐鲁医院心内科

出　　处：《山东大学学报（医学版）》2003年第1期39-40,44,共3页Journal of Shandong University:Health Sciences

摘　　要：目的:探讨风湿性心脏病二尖瓣狭窄(风心二狭)患者经皮球囊二尖瓣扩张术(PBMV)前后肺静脉血流频谱的改变及其与左房压力的相关性。方法:符合PBMV术适应证的风心二狭患者26例,窦性心律组14例,房颤组12例,于PBMV术前后3d内行经食道超声心动图(TEE)检查,记录肺静脉血流频谱,测量收缩期S波、舒张期D波和心房收缩期AR波的峰值流速和流速积分,并与术中记录到的左房压力进行相关分析。结果:与PBMV术前比较,术后二尖瓣口面积扩大犤(0.86±0.14)cm2vs(1.51±0.32)cm2,P<0.01犦,左房压力明显下降。窦性心律患者肺静脉血流频谱S波峰值流速和流速积分与左房压力呈负相关;房颤患者D波峰值流速和流速积分与左房压力呈负相关。结论:肺静脉血流S波是反映二尖瓣狭窄窦性心律患者左房压力的较好指标;D波是反映二尖瓣狭窄房颤患者左房压力的较好指标。Objective:To evaluate the pulmonary ve nous(PV)flow dynamics before and after percufaneous balloon mi tral valvu lo plasty(PBMV)and the correlation between PV flow and left atrial pres sure(LAP).Methods:In a group of26patients with mitral stenosis,14had sinus sinus rhythm and12had atrial fib ril la tion.Be fore and three days after PBMV,transesophageal echocardiography(TEE)was con ducted to recorded the PV flow dynamics,measure the peak flow velocity and velocity-time integrals of systolic PV flow(S),di astolic PV flow(D)and atrial re versal flow(AR).The corre la tion between LAP and peak flow velocity,ve locity-time in te grals of PV flow patterns were also analysied.Re sults:PB MV resulted in signif icant in crease in mitral valve area[(0.86±0.14)cm 2 vs(1.51±0.32)cm 2 ,P<0.01]and sig nifi cant decrease in LAP.LAP corre lated negatively to PV S ,S VTI in sinus rhythm and PV D ,D VTI in atrial fib rilla tion.Con clu sion:The non in vasive parameters obtained from PV flow by Doppler echocardio graphy pro vided us a hemodynam ic assessment of left atrial pressure in patients with mi tral stenosis.

关 键 词：二尖瓣狭窄 超声心动图描记术 经食道 肺静脉血流 左房压力 

分 类 号：R331.1[医药卫生—人体生理学] R540.45[医药卫生—基础医学]