脉冲多普勒定量诊断新生儿及幼婴心力衰竭的价值

VALUABLE STUDY QUANTITATIVE DIAGNOSIS OF NEONATES AND YOUNG INFANTS WITH HEART FAILURE BY PULSED WAVE DOPPLER

用脉冲多普勒测量新生儿及幼婴肺炎心衰10例、肺炎患儿20例及20例正常儿的肺动脉瓣、二、三尖瓣血流参数,以观察心脏收缩及舒张功能改善。结果:1.心衰时肺动脉瓣射血时间缩短(187.850±43.162ms),AT缩短(43.569±11.920ms),AT/DT降低(0.333±0.115)。2.心衰时二尖瓣EAT/EDT明显增大(1.577±0.453)。PEV,PAV,EMV增高,分别为75.185±19.275,67.472±17.802,56.050±15.858。3.心衰时三尖瓣正AT/EDT明显增大(1.712±0.495),PEV,PAV及EMV明显增高分别为75.148±17.255,86.386±0.834,46.590±9.314。4.正常儿与肺炎患儿间各项指标均无显著性差异。作者认为心衰时心脏的收缩及舒张功能均发生明显改变,而以右室的舒张功能变化更为显著,脉冲多普勒对监测心衰时血液动力学改变是一项无创、敏感、定量化的诊断手段。

For the evaluation of the cardiac function and quantitative diagnosis of heart failure in neonates and young infants,10 cases with acute heart failure(Group Ⅰ),20 cases of pneumonia(Group Ⅱ)and 20 normal subjects(Group Ⅲ)were observed with pulsed wave Doppler in all of the cardiac valves. The results show that Group Ⅰ,compare with Group Ⅱ and Ⅲ,has:1.a signi- ficantly reduction of acceleration time of pulmonary valve(PV AT);a decrease of the ratio of acceleration time and decceleration time of pulmonary valve (PV AT/DT);2.sharp reduce of decceleration time and half decceleration time of tricuspid valve(TV EDT and TV 1/2 EDT);remarkable decrease of the ratio of acceleration time and decceleration time of mitral and tricuspid valves(MV EAT/EDT and TV EAT/EDT);3.increase of peak E velocity (PEV)and E mean velocity(EMV)and peak A velocity(PAV)of tricuspid valve. Pulsed wave Doppler,in our opinion,can be used to measure the para- meters of blood flow in all cardiac valves directly and correctly,so it can be used to diagnose neonate and young infant heart failure quantitatively and noninvasively.