高血压致左室流出道梗阻的彩色多普勒超声诊断价值

The Diagnostic Value of Color Doppler Ultrasound in the Left Ventricular Outflow Obstruction with Hypertension

目的:应用二维及彩色多普勒超声观察左室流出道的血流动力学变化,无创性评价高血压致左室流出道梗阻。方法:23例由于高血压导致的左室流出道梗阻患者,根据有无"SAM"征分为两组,无"SAM"征组13例,有"SAM"征组10例。排除肥厚型梗阻性心肌病,心肌梗死及心脏瓣膜病变。分别测量两组患者静息状态和激发试验下左室流出道血流速度及主动脉瓣上血流速度。结果:所有患者在激发试验(Valsal-va试验)后左室流出道血流速度均高于静息状态血流速度,有"SAM"征组静息状态和激发试验后左室流出道血流速度均高于无"SAM"征组,主动脉瓣上血流速度两组患者在静息状态和激发试验后差异无统计学意义。结论:超声心动图能无创、准确诊断左室流出道梗阻,激发试验能有效评价梗阻程度。

Objective-To observe the changes of flow dynamics in left ventricular outflow used 2D and color Doppler ultrasound, non- invasive evaluation left ventrieular outflow obstruction with hypertension. Methods： A total of 23 patients with left ventricular outflow obstruction were enrolled, 23 patients was divided into SAM signs and non - sam signs groups, exclusion hypertrophic obstructive cardiomyopathy, myocardial infarction, valvular disease of the heart. The left ventricular outflow and aortic supravalvular flow velocity were measured in two groups patients at baseline and provocative test conditions. Results： The flow velocity of left ventricular out- flow was significantly increase in the provocative test conditions than baseline. No significantly in the aortic supravalvular flow velocity between two groups at baseline and provocative test conditions. Conclusions：Echocar- diography can non - invasive and accurate evaluation left ventricular outflow obstruction with hypertension, the degree of obstruction can be evaluated by provocative test.