应用肺静脉及二尖瓣血流频谱评价川崎病左心室舒张功能  

Evaluation of left ventricular diastolic function in patients with Kawasaki disease by pulmonary venous and mitral flow

作　　者：刘保民[1] 赵晓兰[1] 裘佩春[1] 李谦[1] 周南[2] 林淑金[2] 

机构地区：[1]西安交通大学第二医院超声研究室,西安710004 [2]西安市儿童医院心肾科

出　　处：《中华超声影像学杂志》2004年第3期186-189,共4页Chinese Journal of Ultrasonography

摘　　要：目的　应用超声技术检测肺静脉血流 (PVF)和二尖瓣血流 (MVF) ,评价川崎病患儿左心室舒张功能改变。方法　 43例川崎病患儿在病程急性期和恢复期分别测量并计算以下数据 :肺静脉血流收缩期峰值流速 (VS)、舒张期峰值流速 (VD)、逆向血流峰值流速 (VA)及VS 与VD 比值 (S/D) ;二尖瓣血流E峰流速 (E)、A峰流速 (A)、E峰减速时间 (DT)及E、A比值 (E/A)。 40例正常儿童作为对照组。结果　川崎病患儿PVF有以下特点 :①急性期D峰小于S峰者较对照组明显增多 ( 2 7/4 3例对 5 /4 0例 )。②VS 在川崎病急性期与恢复期差异无显著性意义 ,而VD 在急性期较正常对照组降低 ,致VS>VD,S/D >1。③在川崎病急性期 ,心房收缩期肺静脉内逆向血流 (Ar)峰检出率较正常婴幼儿组为高。MVF除E/A在急性期较对照组降低外 ,余各数值间差异无显著性意义。结论　应用PVF可能较MVF能更为敏感地反映正常儿童及川崎病患儿左室舒张功能变化。Objective To assess the left ventricular diastolic function of patients with Kawasaki disease (KD), the changes of pulmonary venovs flow(PVF) and mitral valve flow(MVF) were examined. Methods With transthoracic pulsed Doppler transducer located in apex, an apical four chamber view was obtained and the right upper pulmonary vein was clearly shown. PVF and MVF profile were recorded and the following measurements were obtained: maximal flow velocity during systole and diastole (V S, V d), maximal reversal flow velocity during atrial contraction (V A), and the ratio of V S to V D (S/D); maximal velocity in early diastole(E), maximal velocity in atrial contraction(A), the ratio of E/A(E/A),and deceleration time of early diastole wave(DT). Results There were some characteristics of PVF in KD: ①The numbers that D wave < S wave in acute phase in KD were more than those of control group(27/43 cases vs 5/40 cases). ②PVF showed that V D was clearly lower than normal group, while V S was not different compared to control group so that V S>V D, S/D>1. ③Higher examining rate of Ar wave was detected in acute phase in KD. ④V D was improved reversibly in convalescence phase. ⑤MVF showed that only E/A in acute phase in KD was lower than that of normal group. Conclusions It is available and valuable to combine PVF and MVF to assess left ventricular diastolic function in KD.

关 键 词：肺静脉 二尖瓣 血流频谱 川崎病 左心室舒张功能 小儿 超声心动图 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]