组织多普勒测定肺毛细血管楔压评价左室收缩功能的应用研究

目的 探讨应用超声组织多普勒及频谱多普勒综合指标测量肺毛细血管楔压以判定左心功能的可行性.方法 依据二尖瓣瓣环部组织多普勒超声测定各瓣环位点的舒张早期运动速度Ea值,再依据超声血流频谱多普勒测定二尖瓣舒张早期血流速度E峰值,估算出肺毛细血管楔压,据其测量数据将左心功能衰竭的严重程度分为轻、中、重三度,并与患者临床心功能分级进行比较.结果 Ⅰ组患者仅有1例心功能为3级,其余均为2级,占90％,Ⅱ组患者有1例心功能2级,8例心功能为三级占80％,1例心功能为4级,Ⅲ组患者有2例心功能为Ⅲ级,8例心功能为4级,占80％.Ⅰ组和Ⅱ组比较心功能2级和3级差异有显著性意义（P＜0.01）,Ⅱ组和Ⅲ组比较心功能3级和4级差异有非常显著性意义（P＜0.01）.结论 组织多普勒测定肺动脉楔压或肺毛细血管楔压,与临床心功能评价有良好的相关性,是反映左心功能及其前负荷的可靠指标.

Research on application of pulmonary capillary wedge pressure in evaluating left ventricular systolic function by tissue Doppler

Objective Feasibility study on the application of ultrasonic tissue comprehensive index of Doppler and spectral Doppler measurement of pulmonary capillary wedge pressure to determine left ventricular function. Methods Based on the mitral annulus tissue Doppler echocardiography to measure site mitral annular velocity in early diastole E a value, and based on the ultrasonic blood flow Doppler spectrum of mitral early diastolic flow velocity of E peak, estimate the pulmo nary capillary wedge pressure, according to the measured data the severity of left heart failure were divided into light, medium, heavy three degrees, and compared with clinical heart function classification. Results In group Ⅰ were only 1 case of cardiac function of grade 3, the rest are 2, accounting for 90 % of group Ⅱ patients, 1 case of cardiac function of grade 2, 8 cases of cardiac function of three level accounted for 80%, 1 case of cardiac function of grade 4, group Ⅲ patients with cardiac function of 2 patients to grade Ⅲ, 8 patients with cardiac function of grade 4, accounted for 80%. Significant group Ⅰ and group Ⅱ comparison of cardiac function of 2 level and 3 level difference （ P %0.01）, with a very significant comparison of heart function of group Ⅱ and group Ⅲ grade 3 and grade 4 difference （ P %0.01）. Conclusion Tissue Doppler measurement of pulmonary artery wedge pressure or pulmonary capillary wedge pressure, and clinical evaluation of cardiac function has good correlation, is a reflection of the reliability index of left ventrieular function and the load.