多普勒超声检测房、室间隔缺损患者的肺、体循环血流量及分流量  

Doppler Echocardiography for Measuring Qp,Qs,and Shunt volume in Cases with Atrial or Ventriculer Septal Defects

作　　者：张新超[1] 陈树兰[1] 游树荣[1] 张德利[1] 刘霞[1] 沙勇[1] 张金莉[1] 廖明兰[1] 

机构地区：[1]宁夏医学院心血管病研究所

出　　处：《宁夏医学杂志》1992年第5期261-266,共6页Ningxia Medical Journal

摘　　要：运用多普勒超声(DE)技术检测13例房间隔缺损(ASD)和27例室间隔缺损(VSD)患者的肺循环血流量(Qp)、体循环血流量(Qs)及 Qp/Qs 比值和左向右分流量,并将数据与心导管 Fick 法作比较。结果显示,DE 检测的 Qp、Qs 及 Qp/Qs 比值均与 Fick 法结果呈高度正相关性,相关系数 r 分别为0.95、0.91和0.94(P 均<0.001)。DE 测定的 Qp 与 Fick 法测值无显著的统计学差异(P>0.5),Qs 则较 Fick 法者略高(0.01<P<0.05),Qp/Qs 比值较前者略低(0.01<P<0.05)。DE 计算的左向右分流量及 DE 直接测定的跨缺损处分流量与 Fick法实测值之间均无显著差异(P>0.5,>0.1,)并呈良好正相关性(r 分别为0.96、0.93,P<0.001)。作者认为,用 DE 检测 ASD 或 VSD 的 Qp、Qs 及 Qp/Qs 比值,以及由之计算的心内左向右分流量,方法可行,结果可靠;用 DE 直接测跨缺损处分流量,方法简便,初步结果可信,值得进一步研讨。Pulmonary blood flow (Qp),systemic blood flow(Qs), Qp/Qs ratio,and shunt volume were measured in 40 cases with atrial/ven- tricular septal defects(ASD/VSD) using Doppler echocardiography(DE). Values measured by DE were compar- ed with those determined by Fick's method of heart catheterization in order to assess the accuracy of data and clinical applicability of the noninvasive DE technique for estimating shunt magnitude.Qp and Qs were both com- puted by the following formula:flow volume(L/min)=great artery area× mean flow velocity×60/Cos θ.Left to right shunt volume could be obtained by means of one of the fellowing two methods:1.shunt volume=Qp-Qs;2. shunt volnme=defect area(ASD/VSD being assumed to be circular here)× mean shunt velocity×60/Cos θ.ln all cases,Qp and Qs were derived from the main pulmonary artery and accending aorta respectively,both having a 100% success rate of flow volume recording.Qp,Qs,Qp/Qs ratio,and shunt volume(Qp-Qs) measured by DE were correlated exc- ellent to corresponding values from Fick's method,thejr coefficients(r) were 0.95,0.91,0.94,and 0.96 respe- ctively (P<0.001 in every group). There were no significant statisical difference between noninvasive Qp/ shunt volume and corresponding inva- sive datum(P>0.5),whereas Qs det- ermined by DE showed a slight over- estimation while comparing with that from Fick's method(0.01<P<0.05). Shunt volume across defect was calcu- lated directly in 35 cases(12 ASDs and 23 VSDs).An excellent correlation (r=0.93,P<0,001)with negligible difference(P>0.1)was found between shunt volume measured by DE and Fick's method.It is concluded that DE technique in measuring Qp,Qs Qp/Qs ratio,and Left to right shunt volum in cases with ASD/VSD is a practical and reliable method;futher- more,the method for estimating shunt volume across defect with DE directly is simple and convenient,resulting in preliminary promising data.

关 键 词：血流速度 超声检查 心间隔缺损 

分 类 号：R540.45[医药卫生—心血管疾病]