三尖瓣返流时门静脉血流动力学的呼吸性变化

Portal Vein's Respiratory Pulsatility in Normal and Tricuspid Regurgitant Subjects

目的 在正常呼吸情况下对正常人及不同程度的三尖瓣返流患者的门静脉血流频谱进行观察，旨在探索影响门静脉血流稳定性的因素。方法 我们观察了１９ 例正常人及２５ 例不同程度的三尖瓣返流患者的门静脉血流频谱。在正常呼吸的情况下观察门静脉血流频谱的波动性，并计算血流波动系数以及波动系数与三尖瓣返流量的相关系数。结果 正常人门静脉血流频谱随呼吸周期有轻度的波动；三尖瓣返流者门静脉血流的呼吸性变化较正常人显著，且随返流程度的增加而增大，直至出现逆向血流。结论 正常人门静脉血流的波动性与腹压的呼吸性变化以及脾静脉压的呼吸性波动有关。三尖瓣返流组的门静脉血流除受上述因素影响外，还受到返流程度以及返流量的呼吸性波动的影响。

Purpose We conducted this study to determine actors influencing the constant of portal vein flow.Methods The portal vein flows in 19 normal subjects and 25 adults with different degrees of tricuspid regurgitation (TR) were observed by echocardiography.The respiratory pulsatility of flows in portal vein were studied,and the pulsatility index (PI) and the correlative index between the PI and the quantity of TR were calculated.Results There were slight and remarkable pulsatility in portal vein flow respectively in normal and TR subjects;The pulsatility indexes become bigger with more quantity of TR,and reversed flows were found in all the severe TR patients.Conclusions The pulsatility of portal vein flow in normal subjects is influenced by the respiratory changes in abdominal and spleenic vein pressures;besides the above actors the pulsatiluty of portal vein flow in TR patients is also affected by the degree of TR and the respiratory change in the quantity of regurgitation. [