多普勒超声和心导管同步测量肺小动脉嵌顿压的研究

A New Method for Noninvasive Estimation of the Pulmonary Capillary Wedge Pressure -A Simultaneous Doppler Echocardiographic and Cardiac Catheterization Study

为了探讨无创性测量肺小动脉嵌顿压（ＰＷＰ）的新方法，本文在９１例心脏病患者中进行了多普勒超声和心导管技术的对比研究。结果显示：两种技术测量的舒张早期二尖瓣血流最大压差、舒张早期ＰＷＰ和平均ＰＷＰ均高度相关（ｒ分别为０．９５，０．８８和０．９３），表明本文提出的二尖瓣血流压差法为无创性估测ＰＷＰ提供了简便可靠的新途径。

To develop a new method for noninvasive estimation of the pulmonary capillary wedge. pressure (PWP), pressure data were retrospectively analysed in 50 cases (group A), and .Doppler echocardiography (DE) and cardiac catheterization (CC) were simultaneously pre formed in 41 cases (group B) with valvular and congenital heart diseases. The results showed that: 1. the early-disstolic left ventricular pressure (ELVP) was less than 0. 40 kpa in more than 90% cases in group A and hence 0. 40 kpa was thaken as an estimate of ELVP in group B; 2. there was a high correlation between the peak pressure gradients (PPG) across the mitral valve measured by DE and CC (r=0. 95); 3. the early -diastolic PWP (EPWP) which was estimated by adding 0. 40 kpa to PPG correletd well with EPWP measured by CC; (r=0. 88); and 4. the mean pressure gradient determined by DE correlated highly with the mean PWP by CC (r=0. 93). In conclusion, our method offers a new and reliable approach to the noninvasive estimation of PWP.