冠心病左室舒张功能障碍的超声多普勒检查方法及诊断价值研究

Diastolic dysfunction of Left Ventricle in Patients With coronary Heart disease(CHD) -A Study by Duplex Doppler and its Diagnostic Value.

本研究选择冠心病人50例(心肌梗塞30例,心绞痛、无症状性心肌缺血20例),正常对照组20例,分别应用脉冲多普勒和连续多普勒记录和测量二尖办频谱的E峰和A峰及A/E比值,右肺上静脉频谱的收缩期最大速度VS和舒张期最大速度VD及两者比值(VS/VD),左室等容舒张时间(IVRT)。结果显示冠心病组24例A/E>1,阳性率为55%;36例VS/VD>1,阳性率为82%,A/E>1或VS/VD>1与IVRT异常(大于X+S或小于X-S)42例,阳性率为95%。本研究结果表明:二尖瓣频谱结合肺静脉频谱和等容舒张时间的分析,是评价冠心病左室舒张功能障碍的可靠方法,且对于分型、病因病情的判断以及药物疗效的评价都具有重要的价值。

50 cases of coronary heart disease (including 30 myocardial infarction, 20 angina or asymptomatic myocardial ischemia) and 20 healthy adults as the control group were studied by pulsed Doppler and continual Doppler. The values of mitral peak E. peak A, A/E ratio, systolic peak velocity of right upper pulmonary vein(VS). diastolic velocity(VD) and their ratio (VS/VD). isovolumetric relaxation time(IVRT) were measured. The results showed;A/E>1 appeared in 24 cases with a 55% positive rate;VS/VD>1 happened in 36 cases with a 82% positive rate;A/E>l or VS/VD>1 and a abnormal TVRT (more than X + S or less than X-S) happened in 42 cases with a total positive rate of 95%. In conclusion. Doppler spectrum of mitral valve and pulmonary veins combined with IVRT was not only a reliable method to evaluated diastolic dysfunction of left ventricle, but was of great value in classification) condition analysis and treatment effects.