老年动脉导管未闭患者彩色多普勒超声心动图特征研究

目的探讨老年动脉导管未闭(PDA)患者彩色多普勒超声心动图(CDE)特征。方法选择老年PDA患者25例,应用彩色多普勒血流显像(CDFI)分流束血流信号估测PDA肺动脉端直径,与心血管造影对比判断其准确性;连续波多普勒测量三尖瓣最大反流速度峰值,与心导管对比判断其准确性。结果 M型超声和二维超声心动图显示左心房(100%)、左心室(88.0%)内径不同程度增大,室间隔与左心室后壁运动幅度增大。所有患者CDFI均显示过动脉导管左向右五彩镶嵌分流束血流信号。PDA肺动脉端直径与心血管造影呈正相关(r=0.71,P<0.01);连续波多普勒估测肺动脉压力与心导管呈正相关(r=0.63,P<0.01)。合并二尖瓣关闭不全占88.0%、主动脉瓣关闭不全占80.0%、三尖瓣关闭不全占60.0%、肺动脉瓣关闭不全占28.0%。老年PDA患者合并肺动脉高压明显增多,占60.0%。女性(96.0%)明显多于男性(4.0%)。结论老年PDA患者的CDE特征明显,有特异性诊断价值。

Characteristics of color Doppler echocardiography in old patients with patent ductus ateriosus

Objective To study the characteristics of CDE in old patients with PDA.Methods Characteristics of CDE were detected in 25 old PDA patients.Diameter of PDA at the pulmonary artery end was measured using the shunt flow signal of CDFI and its accuracy was determined by comparing it with the angiocardiographic findings.The peak velocity in tricuspid was measured with the continuous wave Doppler.Their accuracy was assessed by comparing them with the findings in cardiac catheterization.Results The M mode echocardiography and two-dimensional echocardiography showed 100%left atrium,88.0%enlarged left ventricles,and increased movement of ventricular septum and left ventricular post wall.The diameter of PDA at the pulmonary artery end was positively correlated with the angiocardiographic findings according to the shunt flow signal width measured by CDFI(r=0.71,P<0.01).The pulmonary artery pressure estimated by the continuous wave Doppler was positively correlated with the findings in cardiac catheterization(r= 0.63,P<0.01).Of these patients,88.0%,80.0%,60.0%and 28.0%were complicated with mitral, aortic,tricuspid and pulmonary insufficiency,respectively.The number of elderly PDA patients accompanying pulmonary arterial hypertension increased significantly,accounting for 60.0%.The incidence of PDA was significantly higher in old females than in old males(96.0%vs 4.0%).Conclusion The characteristics of CDE are significant in elderly PDA patients and CDE is thus of great value for the specific diagnosis of PDA in the elderly.