肺静脉血流定量评定左室舒张功能的临床研究

目的:探讨肺静血流频谱评价高血压病患者左室舒张功能减退程度的价值。方法:确诊的原发性高血压病患者69例根据超声心动图检查结果被分为左室肥厚组(LVH)和无肥厚组,28例健康志愿者作为正常对照组。应用HPSonos2500型超声诊断仪和2.5MHz超声探头记录心尖四腔切面,二尖瓣口和右上肺静脉入口处多普勒血流图。结果:(1)不同组间二尖瓣血流频谱各指标无差别。高血压LVH组较无LVH组及正常组肺静脉血流AR波持续时间(ARD)显著延长(110.21±18.39∶89.78±20.12、90.93±13.11,P<0.01),ARD/AD(A波持续时间)显著增大(1.18±0.40∶0.91±0.19、0.81±0.20,P<0.01);S波流速积分(VTIs)/S、D波流速积分之和(VTIs+VTId)较其它两组低(0.51±0.09∶0.62±0.12、0.60±0.11,P<0.01);(2)在二尖瓣血流正常的高血压病患者中,左室肥厚组较之无肥厚组二尖瓣血流E/A比值显著增大(1.37±0.37∶1.06±0.65;P<0.01);肺静脉血流频谱的ARD、ARD/AD(ARD:120.15±26.60∶82.37±16.38,P<0.05;ARD/AD:1.38±0.34∶0.73∶0.25,P<0.01)明显增大。结论:综合二尖瓣及肺静脉血流频谱可以更全面反应左室的舒张功能,检测不同程度的舒张功能不全。

Evaluating the degree of left ventricular diastolic function in hypertension patients by Doppler pulmonary venous flow

ve:To evaluate the degree of left ventricular diastolic dysfunction in hypertension patients by Doppler pulmonary venous flow (PVF). Methods: Sixty-nine hypertension patients were divided into two groups according to left ventricular hypertrophy (LVH) : left ventricular hypertrophy group. no LVH group. Control group consisted from 28 normal subjects. Echocardiography system and 2. 5MHz transducer were used for recording pulmonary venous flow (PVF) and mitral flow pattern (MFP). Results: (1) Compared with no LVH group and normal group. AR wave duration (ARD) and the ratio of AR wave duration to A wave duration (ARD/AD) increased (P<0. 01 all); the ratio of S wave velocity time integrality to sum of S wave and D wave velocity time integrality [VTIs/ (VTIs + VTId)] decreased (P<0. 01) in LVH group; (2) In hypentension patients with normal mitral flow, compared with no LVH group the E/A,ARD and ARD/AD of LVH group increased (P<0. 01, P<0. 05, P<0. 01 respectively). Conclusion: MFP can not validity reflect left ventricular diastolic dysfunction in patients with hypertension, PVF combination MFP seems useful to evaluate the degree of left ventricular diastolic dysfunction.