多普勒超声心动图对房缩期肺静脉返转血流与肺毛细血管楔嵌压关系的临床研究

Clinical Study on the Relationship between Reversal Flow in Pulmonary Veins and Pulmonary Capillary Wedge Pressure during Atrial Contraction by Echocardiography

目的探讨应用多普勒超声心动图观察房缩期肺静脉返转血流估测平均肺毛细血管楔嵌压（ＭＰＣＷＰ）的新途径。方法观察２６例先天性心脏病（先心病）病人的房缩期肺静脉返转血流的特点，与导管测得的ＭＰＣＷＰ进行相关比较分析。结果先心病人的房缩期肺静脉血流参数中，返转血流峰值流速（Ｚｐ）与ＭＰＣＷＰ相关性好（ＭＰＣＷＰ＝１．０４＋０．３４Ｚｐ，ＳＥＥ＝３．５９ｍｍＨｇ，ｒ＝０．７６，Ｐ＜０．０１）。多元逐步回归表明，ＳＢＰ、ＤＢＰ、ＨＲ、年龄均无显著影响。结论Ｚｐ是估测先心病人ＭＰＣＷＰ的较好指标，观察房缩期肺静脉返转血流可为无创估测ＭＰＣＷＰ提供新途径。

\ Objective\ To explore whether variables of reversal flow in pulmonary vein during atrial constraction measured by Doppler echocardiography could be used to estimate mean capillary wedge pressure(MPCWP).\ Methods\ 26 consecutive patients with congenital heart diseases were investigated and Doppler variables of reversal flow were correlated with MPCWP measured by cardiac\ catheterization.\ Results\ Among the variables of reversal flow,peak flow velocity(Zp) correlated most strongly with MPCWP(MPCWP=1 04+0 34Zp,SEE=3 59 mmHg,r=0 76,P<0 01) \ A multiple stepwise linear regression analysis showed that none of SBP,DBP,HR and age significently confounded this relationship.\ Conclusion\ Zp was better variable which could estimate MPCWP in patients with congential heart disease.this study indicated that using Doppler-determined pulmonary venous atrial flow reversal might offer a new approach to noninvasive estimation of MPCWP. \ \