房或室间隔缺损的房室瓣和肺动脉瓣多普勒血流速度分析

Analysis of Blood Flow Velocity Across Atrio-Ventricular Valve and Pulmonary Valve by Doppler Echocardiography in Patients of Atrial or Ventricular Septal Defect

目的 :总结分析房或室间隔缺损的房、室瓣 (MV、TV )和肺动脉瓣 (PV)多普勒血流速度变化的临床意义。材料和方法 :83例房或室缺患者 ,根据不同病理生理状况分为 5组 ,在手术或介入性治疗前后检测其MV、TV、PV瓣下 (PV sub)和瓣上 (PVsup)血流速度。 结果 :房缺TV和PV前向血流速度加快 ,TV与MV流速比值逆转≥ 1,PVsub与PVsup流速差值加大。室缺MV和PV前向血流速度加快 ,PVsub与PVsup流速差值变化不明显。房或室缺最大径与MV、TV、PV流速中度相关 ,出现肺动脉高压 (PH)时相关性下降。房或室缺伴PH组的缺损最大径明显大于不伴PH组。房缺伴轻度肺动脉瓣狭窄时的PV最低流速与单纯房缺的最高流速间有一小范围的重叠区域。结论 :认真分析房或室缺的MV、TV和PV多普勒血流速度对房或室缺的辅助诊断并对了解有类似左向右分流病变的病理生理机制均有裨益。

Purpose: To study the clinical significance of velocity changes of atrio ventricular and pulmonary valve by Doppler echocardiography in patients of atrial or ventricular septal defect (ASD or VSD). Materials and Methods: 83 cases of ASD or VSD were divided into 5 groups according to their pathological condition. The blood flow velocity passthrough mitral valve (MV), tricuspid valve (TV), subpulmonary valve (PV sub) and suprapulmonary valve (PV sup) were measured by Doppler echocardiography before and after surgical or interventional treatment. Results: In ASD, the blood velocities of TV and pulmonary valve (PV) were increased, the ratio of TV to MV was inversed (≥1), the difference between blood velocities below and above PVsup was increased. In VSD, the blood velocities of MV and PV were increased, but the velocities across PVsub did not change obviously. There was a moderate correlation between maximum diameter of ASD or VSD and blood velocities of TV?MV and PV, but the correlation was weakened when pulmonary hypertension (PH) occured. The septal defect of ASD or VSD complicated with PH was bigger than that without PH. The maximum velocity of ASD overlapped the minimum velocity of ASD complicated with mild pulmonary valve stenosis. Conclusion: The analysis of blood velocity of TV?MV and PV in ASD and VSD by Doppler echocardiography was helpful in clinical diagnosis and pathophysiological study of those congenital disorders.