肺静脉血流频谱评价冠心病患者左心室舒张功能的价值

目的：应用彩色多普勒超声心动图研究冠心病患者肺静脉血流频谱对左心室舒张功能的价值。方法：用彩色多普勒超声心动图检测冠心病患者和相同年龄组正常人各45例的右上肺静脉血流频谱峰值（Sp、Dp、ap）及其速度时间积分（Si、Di、ai），与所检测的二尖瓣口血流频谱峰值（Ep、Ap)、速度时间积分（Ei、Ai)及等容舒张时间相比较，将结果对比分析。结果：冠心病组ap、ai较正常组显著增大，Si、Dp、Di和Dp/ap、Di/ai值明显减小，ap、ai增大幅度与左室舒张功能明显相关。二尖瓣口血流频谱测值一般反映了左室舒张功能状态，但对几例出现的“伪正常”频谱表现难以明确评价。结论：肺静脉血流可直观反映冠心病患者左心房内的压力状态，其频谱特征与二尖瓣口血流频谱结合评价左室舒张功能较用二尖瓣口血流频谱一种方法更加准确可靠。

The study of pulmonary venous spectrum assessment of left ventricular diastolic function in patients with coronary artery disease

Objective To assess the value of pulmonary venous spectrum assessment of left ventricular diastolic function in coronary artery disease by color Doppler echocardiography. Methods Forty five patients with coronary artery disease and 45 normal subjects of the same age group were detected by color Doppler echocardiography, peak velocity (Sp,Dp,ap) and velocity time integral(Si,Di,ai) of right upper pulmonary venous flow were compared with the peak velocity(Ep,Ap), velocity time integral(Ei,Ai) of mitral valve flow and isovolunmic relaxation time.Results In the aspect of the right upper pulmonary venous flow spectrum,the ap, ai of coronary artery disease group were obviously greater than normal group, Si, Dp, Di and Dp/ap, Di/ai were significantly smaller, the increase degree of ap,ai was significantly correlate with left ventricular diastolic function.Mitral valve flow spectrum commonly reflect the state of left ventricular diastolic function, but several cases with pseudonormalization spectrum can't be clearly assessed.Conclusions Pulmonary venous flow can directly reflect the state of left atrium pressure, and combining with mitral valve flow spectrum to assess left ventricular diastolic function is more accurate and reliable than only using mitral valve flow spectrum.