单瓣置换手术前后左室压-容积环变化的临床研究

The Study of Left Ventricular Pressure-volume Loops Before and After Single Vaive Replacement

研究了15例单瓣置换病人。分二尖瓣关闭不全（MR）组（n＝6），二尖瓣狭窄（MS）组（n＝6），主动脉瓣关闭不全（AR）组（n＝2），主动脉瓣狭窄（AS）组（n＝1）。手术前后以心外膜超声测左室容积，同时测左室压，绘制左室压－容积环。结果：MR组术后舒张未容积（EDV）减少，收缩末压（ESP）增加，左室压－容积环面积大大减少；MS组术后EDV增加，ESP上升；AR组舒张本压（EDP）、EDV增加，术后下降；AS病人术后ESP下降。结论：MR病人术前前负荷增加，有效排血量减少处于高做功状态，术后后负荷明显增加，做功减少；MS病人术后前负荷、压力负荷较术前增加；AR组术前前负荷增加，术后下降；AS病人术后后负荷下降。

Fifteen patients with valvular disease have been invesigated. They were grouped into mitral regurgitattion (MR) group (n=6), mitral stenosis (MS) group (n=6), aortic regurgitation (AR) group (n=2) andaortic stenosis, (AS) group (n=1). Epicrdial echocardiography was used to measure the left ventricular volume,in the meantime, a catheter was inserted into the middle of the left ventricte to measure pressure. The data of volume and pressure were plotted with graphtool so as to delineate the 2 - D left ventricular pressure volume loops.Conclusion: Before operation, MR group are in the state of high working state and both their left ventricular preloadand afterload are increased, the effective cardiac output decreses, after surgery the afterload increases much more;in MS group, after the procedure; the preload and pressure load are increased as compared with those before the procedure, in AR group after the procedure, left ventricular diastolic funtion ameliorates; in AS group after surgery,the afterload decreases.