多普勒超声心动图检测肺静脉及二尖瓣血流评价左室舒张功能

目的　探讨经胸多普勒超声心动图检测肺静脉血流频谱（ＰＶＦＰ）及二尖瓣血流频谱（ＭＶＦＰ） 的变化无创评价左室舒张功能的价值。方法　选择４０ 岁以上的无心脏疾患者３０ 例为对照组；高血压病左房不大组３０ 例；冠心病左房不大组３０ 例；高血压或冠心病左房扩大组３０ 例共１２０ 例为研究对象。使用经胸多普勒超声心动图记录肺静脉及二尖瓣血流频谱，观察各组病人肺静脉及二尖瓣血流速度的变化和左室舒张功能的关系。结果　高血压或冠心病左房不大组与对照组比较，ＭＶＦＰ 中Ｅ 峰速度减低，Ｅ 峰减速时间延长，Ａ 峰速度增高，Ｅ／Ａ 比值减低。ＰＶＦＰ中Ｓ峰速度增快，ＳＦ增大，二组之间有明显差异（ Ｐ＜ ００１） ；高血压或冠心病左房扩大组与对照组比较ＰＶＦＰ中Ｓ峰速度减低，ＳＦ减低，ＰＡ 速度增快、间期延长，ＰＡｄ ＞ Ａｄ（ Ｐ＜ ００１） ，而ＭＶＦＰ除ＥＤＴ 缩短以外，Ｅ、Ａ 峰速度、Ｅ／Ａ 比值二者近似（ Ｐ＞ ００５） 。结论　超声心动图记录肺静脉及二尖瓣血流变化能够较全面地评价左室舒张功能。

Estimation of Left Ventricular Diastiolic Function from Pulmonary Venous Flow Pattern and Mitral Valve Flow Pattern by Doppler Echocardiography

Objective Estimation of left ventricular diastolic function(LVDF) from pulmonary venous flow pattern (PVFP)and mitral valve flow pattern (MVFP)by Doppler echocardiography (DE).Methods 30 subjects without cardiac disease and 30 patients with hypertension of no left artial enlargement and 30 patients with coronary artery disease of no left artial enlargement and 30 patients with hypertension or coronary artery disease of left artial enlargement was studied. The variables of PVFP and MVFP recorded by DE was observed.Results The significant difference was found between the subjects and the patients with hypertension or coronary artery disease of no left artial enlargement. The variables of following indices was found including that E velocity was decreased, A velocity was increased, and E/A ratio was decresed.EDT was incresed in MVFP and that S velocity and SF was increased in PVFP( P <0 01). The significant difference was found between the subjects and the patients with hypertension or coronary artery disease of left artial enlargement.The variables of following indices was found including that E velocity was increased and A velocity was decreased, E/A>2,that EDT was decreased in MVFP and that S velocity and SF was decreased,PA velocity and duration was increased in PVFP and that PAd exceed Ad( P <0 01). Conclusion LVDF could be estimated from PVFP and MVFP recorded by DE.