肺静脉血流识别二尖瓣血流假性正常化的临床研究

目的　探讨肺静脉血流频谱识别二尖瓣血流频谱假性正常化的临床意义及价值。方法　临床确诊为原发性高血压病患者 6 9例。根据超声心动图 ,分为左室肥厚组和非肥厚组。 2 8例正常对照组。应用HPSonos 2 5 0 0超声诊断仪和 2 5MHz的超声探头记录二尖瓣口和右上肺静脉入口处多谱勒血流图。结果　 (1)不同组间二尖瓣血流频谱各指标比较无差别。肺静脉血流的ARD在高血压LVH组较无LVH组及正常组延长(P <0 0 5 ) ;VTIs(VTIs+VTId)在高血压LVH组较其它两组低 (P <0 0 5 ;ARD/AD在高血压LVH组较其它两组高 (P <0 0 5 ) )。 (2 )在左室壁肥厚组 ,二尖瓣血流表现出更高的E/A比值 (P <0 0 1) ;肺静脉血流频谱的ARD、ARD/AD较不肥厚组明显增大 (ARD :P <0 0 5 ;ARD/AD :(P <0 0 1)。结论　综合二尖瓣及肺静脉血流频谱可以识别二尖瓣血流频谱假性正常化 ,更全面反应左室的舒张功能。

The Clinic Study on Evaluation of Pseudonormalized Mitral Flow Pattern by Pulmonary Venous Flow

Objective To evaluate the role of Doppler pulmona ry venous flow (PVF) in assessing the pseudonormalized Prion mitral flow pattern ( MVF). Methods According to myocardial hypertrophy, 69 hypertensi v e patients were divided into two groups: left ventricular myocardial hypertrophy group and without left ventricular myocardial hypertrophy group. The third grou p included 28 normal people as control group. Hewlett Packard Sonos 2500 Echocar diographic system and 2.5 MHz transducer were used for recording PVF and MVF. Results 1.Compared with the patients in group II(without left ve ntri cular myocardiar hypertrophy) and normal subjects (in group III), AR wave durati on(ARD) and the ratio of AR wave duration (ARD/AD) in group I (left ventricular myocardial hypertrophy) were increased(P<0.05).VTIs/(VTIs+VTId) in group I was lower than that in group II and III (P<0.05). 2. The ratio of E wave velocith to A wave velocity (E/A) in group I was higher than that in group II ( P<0.01). So were ARD and ARD/AD (P<0.05 and 0.01, RESPECTIVELY). Conclusion MVF could not validity reflect left ventricular diastoli c dysfunction in patients with hypertension, PVF played an important role in dif ferentiating pseudonormalized MVF. It seems useful to use PVF combination with M VF to evaluate the degree of left ventricular diastolic dysfunction.[