彩色多普勒超声对主动脉瓣病变致颈动脉血流动力学变化的观测价值

Diagnostic value of the color doppler ultrasound on carotid artery hemodynamics caused by aortic valve disease

目的探讨彩色多普勒超声在主动脉瓣病变返流患者致颈动脉血流动力学变化。方法对2003年6月-2009年10月对主动脉瓣返流患者(观察组)126例及无主动脉返流正常患者(正常组)126例,应用飞利浦HD-6型彩色多普勒超声波诊断仪观测颈动脉血流动力学变化情况。结果正常组颈动脉彩色流充盈于管腔层流,明亮高速,频谱形态呈三峰型,收缩期呈空窗型,舒张期频谱稍增宽,早期增速为第三峰,可有反向频谱,△T/T比值<1/10。观察患者颈动脉收缩期V1、AC、DC均显著增大;舒张期出现返流频谱,即△T/T比值≥1/10。结论彩色多普勒超声可作为主动脉瓣返流分级的一种简便辅助方法。对临床听不到杂音的主动脉瓣返流患者,颈动脉"返流频谱"可作为病变线索存在。

Objective To evaluate the diagnostic value of the color doppler ultrasound on carotid artery hemodynam- ics caused by aortic valve regurgitation. Methods By using the Philips HD 6 color doppler ultrasonic diagnostic apparatus, the carotid artery hemodynamics changes of 126 patients with aortic valve regurgitation （observation group） and 126 healthy people （control group） was observed. Results The normal common carotid artery doppler waveforms showed three peaks. There were possible inverse frequency spectrum in early diastole （ AT/T ratio 〈 1/10）. The valves of V1 ,AC and DC of the observation group in carotid artery systolic were significantly larger than that of the control group, ＂retrograde flow＂waveforms could appear in diastole among the observation group （ AT/T ratio≥ 1/10）. Conclusion The color doppler ultrasound could serve as a simple helpful method for grading the degree of aortic valve regurgitation. For the patients with aortic valve regurgita- tion who had not an audible murmur clinically,＂ retrograde flow＂ waveforms could be a useful clue which suggested the aortic valve diseases existed.