肺动脉瓣球囊扩张术前后应用多普勒超声估测跨瓣压差的临床价值研究

Application in percutaneous balloon pulmonary valvuloplasty (PBPV) of Doppler echocardiography: compared with catheterization

目的 通过与心导管测量对比来评价经皮肺动脉瓣球囊成形术（PBPV）前后应用Doppler超声心动图估测跨瓣压差的临床价值。方法 对178例患者在行PBPV术前利用Doppler测量肺动脉瓣跨瓣压差（△P’）,与相应的心导管测量值（△P）作相关性分析;并利用Doppler对PBPV术后48例患者进行了4～102个月（平均19.5个月）的随访。结果Doppler测量的△P’值与导管测量的△P值之间有着良好的直线相关性,r值为0.80,P<0.05;随访中Doppler测量的△P’值与PBPV术后即刻导管测量的△P值之间差异无显著性（P=0.05）。结论Doppler超声作为一种准确、无创、简便而有效的检查方法,对估计PBPV术前肺动脉瓣狭窄程度,评价术后疗效有较高的临床应用价值。

Objective To assess the value of Doppler applicating in estimating the gradients across pulmonic valve (PG) pre-valvuloplasty and post-valvuloplasty (compared with catheterization) . Methods PBPV was performed on one hundred and seventy-eight patients with valvular pulmonary stenosis. The gradient across pulmonic valve was measured by Doppler and catheterization before valvuloplasty respectively, and the linear correlation between two methods was analyzed. Forty-eight patients were follow up for 4-102 months (average 19.5 months) by Doppler examination. Results There was a good correlation between the simultaneous pressure gradient estimated by Doppler and the peak-to-peak pressure gradient measured by catheterization (r = 0.80). And there was no significant difference between the PG estimated by Doppler in follow-up and the PG measured by catheterization after valvuloplasty immediately (P = 0.05) . Conclusion As a noninvasive. accurate and simple method, Doppler would play a great role in estimating degree of stenosis pre-valvuloplasty and assessing curative effect post- valvuloplasty.