多普勒超声心动图测量肺血管阻力

Estimation of pulmonary vascular resistance by Doppler echocardiography

目的:探讨多普勒超声心动图无创测量肺血管阻力(PVR)的方法。方法:采用多普勒超声技术检测22例正常儿童(对照组)和50例经右心导管检查的先心病患儿(病例组)的三尖瓣最大反流速度(TRV)、右室流出道血流速度时间积分(VTIRVOT)、肺动脉瓣最大反流速度(PIV)、肺动脉血流速度时间积分(VTIPA),计算TRV/VTIRVOT值、TRV/VTIPA值及PIV/VTIPA值,比较两组的差异,并将病例组TRV/VTIRVOT值、TRV/VTIPA值及PIV/VTIPA值与导管所测的PVR进行相关与回归分析。结果:对照组与病例组的TRV/VTIRVOT、PIV/VTIPA及TRV/VTIPA值差异有显著性意义(P<0.05),且病例组的PIV/VTIPA值和TRV/VTIPA值与心导管所测PVR值间呈高度正相关(r=0.896,0.847,P<0.05);当PIV/VTIPA>1.069或TRV/VTIPA>1.407时,提示PVR>2 Wood单位。结论:多普勒超声技术可以比较准确地估测肺血管阻力。

Objective：To expiate noninvasive estimation of the pulmonary vascular resistance（PVR） by Doppler echocardiography. Methods：The peak of velocity tricuspid regurgitant （TRV） of velocity-time integral of the right ventricular outflow tract （VTIRVOT）, of velocity-time integral of the pulmonary tract （VTIPA）, and pulmonary regurgitant velocity（PIV） were obtained by Doppler echocardiography in 22 normal children and 50 children with congenital heart disease undergoing heart catheterization. The data of the two group were compared between the normal children and the patients. And the US data were then compared correlation with PVR calculated by cardiac catheterization. Results ： There were significant differences between the normal children and sick group （ P 〈 0.05） in TRV/VTIRVOT、PIV/VTIPA and TRV/VTIPA. There are post correlation between PIV/VTIPA and TRV/VTIPA calculated by Doppler echocardiography and PVR measured by cardiac catheterization （ r = 0. 896,0. 847, P 〈 0.05）. When PIV/VTIPA value 〉 1. 069, or TRV/VTIPA value 〉 1.407 indicated PVR 〉 2 Wood units.Conclusion：PVR could be accurately estimated by Doppler echocardiography.