冠心病左心功能不全时肺静脉内径的变化

目的　探索肺静脉内径变化在诊断冠心病左心功能不全时的临床意义。方法　应用二维超声心动图测定 90例正常健康者和 13 2例冠心病患者不同心功能分级时肺静脉显示情况及其内径和左心室射血分数 ,同时测量左心室长轴与主动脉长轴之间的夹角 ,并与正常组对照。结果　冠心病组左心室长轴与主动脉长轴之间的夹角变小 ,右上、左上、左下肺静脉显示率低于正常对照组 ,右下肺静脉显示率高于正常对照组 ,而且心功能越低其显示率越高。左心功能 ～ 级时肺静脉内径与正常对照组相比无明显变化 ,左心功能 ～ 级时肺静脉内径与正常对照组相比明显增宽 (P<0 .0 5 )。结论　左心功能轻、中度减退时不引起肺静脉形态学变化 ,当肺静脉内径增宽 (≥ 1.2 5 cm)时 ,提示临床上存在严重左心功能不全 (左心功能≥ ～ 级 ) ,可作为超声诊断冠心病患者左心功能不全的肺静脉指标

Changes of inside diameter of the pulmonary venous in the coronary heart disease patients with left ventricular dys function

Objective To study the changes of inside diameter of the pulmonary venous (PV) in the coronary heart disease (CHD) patients with left ventricular dysfunction (LV) and its clinical significance. Methods The inside diameter of PV and PV showing,left ventricular rejection fraction (LVEF) and the angle between the long axis of lefet ventricle (LV) and aorta (AO) was determined by two dimension echocardiography in 90 casese of healthy subjects and 132 cases of coronary heart disease with left ventricular dysfuction.The results were compared. Results For patients with CHD the angle between the long axis of LV and AO became smaller, PV showing rates of the right superior, the left superior and the left inferior in patients with CHD were lower than those in healthy subjects , but PV showing rates of the right inferior in patients with CHD was higher than that in healthy subjects.For patients with left heart function of grade Ⅰ and Ⅱ,there's no obvious change in the inside diameter of their PV, for patients with the left heart function of grade Ⅲand Ⅳ,the PV inside diameter increased( P <0.05).Conclusions The slight and intermediate dysfunction of the left heart would not cause any changes in morphology of PV. However, when the inside diameter of PV increased(≥1.25 cm), it means serious LV dysfunction (of the grade higher than Ⅲ or Ⅳ), and can be used as a PV index for the diagnosis of LV dysfunction in patients with CHD by using two dimension echocardiography.