呼吸运动对健康成年人上腔静脉多普勒频谱影响研究

Effluence of physiologic respiration on the spectrum of superior vena cava of health adult

目的探讨健康成年人上腔静脉(SVC)频谱各波峰值及速度时间积分(VTI)随生理呼吸变化的规律。方法经右侧锁骨上窝切面探查44名健康成年人的SVC,记录呼吸周期中SVC主波流速最大的频谱曲线和流速最小的频谱曲线各波峰值及VTI,计算各波峰值及VTI随呼吸的最大变化率,结果用统计软件Spss11.0行多组均数差别多重比较的方差分析。结果健康成年人SVC频谱各波峰值及VTI随生理呼吸的变化有一定的规律:S波与D波之间、VR波与AR波之间峰值速度的吸气变化率(ICR)及呼气变化率(ECR)无显著差异(P>0.05)。S波、D波峰值速度ICR大于ECR(P<0.05);VR波、AR波峰值速度的ECR与ICR无显著差异(P>0.05)。S波与D波之间VTI的ECR与ICR差异显著(P<0.05),D波VTI的ICR及ECR均比S波大;VR波、AR波的VTI之间差异显著(P<0.05),AR波ICR大于VR波,VR波ECR大于AR波。S波、D波、AR波VTI的ICR均大于ECR(P<0.05),VR波VTI的ECR大于ICR(P<0.05)。结论健康成年人SVC频谱各波峰值及VTI随生理呼吸出现规律性变化,对这种变化规律的认知,有助于SVC超声检查临床应用价值的深入研究。

Objective Aimed to study the rule of effluence of physiologic respiration on the spectrum of superior vena cava （SVC） of health adult. Methods Through supraclavicular fossa view, SVC of 44 health adults were examined. Maximum and minimum flow velocity spectra in respiration cycle were recorded, peak velocities and velocity time integrals （VTI） of them were measured, and ratios of their changes were analyzed with spss 11.0. Results Peak velocities and VTI of the spectra of SVC of health adults changed regularly in physiologic respiration cycle. There were no significant differences in inspiration changes ratios （ICR） and expiration changes ratios （ECR） of peak velocities between wave S and wave D and between wave VR and wave AR （ P 〉 0.05）. ICR of peak velocities of wave S and wave D were higher than their ECR, but there were no significant differences ICR and ECR in peak velocities of wave VR and wave AR （ P 〉 0.05）. ICR and ECR of VTI of wave D were higher than that of wave S （ P 〈 0.05） ; ICR of VTI of wave AR was higher than that of wave VR, and ECR of VTl of wave VR was higher than that of wave AR（P 〈0.05）. ICR of VTI were higher than ECR in wave S, wave D and wave AR; ECR of VTI was higher than ICR in wave VR （ P 〈 0.05）. Conclusion Peak velocities and VTI of SVC of health adult changed regularly in respiration cycle, which could conduce to elaborate study on SVC in clinical ultrasonography.