风湿性二尖瓣病变时肺动脉压力变化及其相关性分析的超声研究

目的通过多谱勒超声心动图无创监测手段,了解风湿性二尖瓣狭窄/关闭不全时肺动脉压力变化情况及其相关性因素。方法 回顾性分析我院自1999年6月至2001年4月间收治的风湿性二尖瓣病变患者,应用超声心动图观察单纯二尖瓣狭窄及二尖瓣狭窄合并关闭不全时肺动脉收缩压、左房内径、二尖瓣瓣口面积及左室功能等指标,计算二尖瓣跨瓣压差,并进行相关性分析。结累单纯二尖瓣狭窄组肺动脉收缩压显著低于合并关闭不全组。线性相关性分析显示:肺动脉收缩压同二尖瓣舒张期跨瓣压差间呈线形相关。重度肺动脉高压组的肺动脉收缩压同二尖瓣跨瓣压差间的差值显著高于非重度肺动脉高压组。结论应用超声心动图无创手段可监测风湿性二尖瓣病变时肺动脉收缩压变化情况,此时肺动脉收缩压变化同二尖瓣跨瓣压差呈线性相关性。二级狭窄在肺动脉压力的演变中起着重要作用。

Changes in pulmonary pressure in patients with rheumatic mitral valve disease and factors causing the changes: analysis by color Doppler echocardiography

Objective To study the changes in pulmonary artery systolic pressure and the related factors in patients with rheumatic mitral valve disease by color Doppler echocardiography. Methods From June, 1999 to March,2000 we conducted analyses of the pulmonary artery systolic pressure (PAPS), left atrial dimension, mitral valve diastolic pressure decrease, mitral valve open area and left ventricular function in patients with mitral stenosis (MS) and in patients with MS and MI by color Doppler echocardiography retrospectively. Results The PAPS in patients with MS were significantly lower than that in patients with MS and ML Linear regression analysis showed correlation between PAPS and mitral valve diastolic pressure decrease, and the differences between them were significantly greater in patients with serious PAPS than in the control. Conclusion Color Doppler echocardiography can be used for non-invasive monitoring of PAPS in patients with rheumatic mitral valve disease, and PAPS is related mainly with mitral valve diastolic pressure decrease. The second grade stenosis plays important roles in PAPS progression.