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多普勒二维超声心动图测定风心病二尖瓣狭窄患者的肺静脉血流

PULMONARY VENOUS FLOW VELOCITY DETERMINED BY DOPPLER ECHO-CARDIOGRAPHY IN RHEUMATIC MITRAL STENOSIS
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摘要 本文使用脉冲多普勒超声心动图(日本产,东芝B—25型)测定肺静脉血流速率和血流频谱(采用Keren’s法)。病人分两组:第一组为轻至中度风心病二尖瓣狭窄22例(男10例,女12例,平均年龄39±12.6岁,平均二尖瓣口面积1.2±0.3cm^2,平均肺动脉嵌楔压2.93±0.33Kpa),第二组为重度风心病二尖瓣狭窄18例(男8例,女10例,平均年龄41±14.2岁,平均二尖瓣口面积0.7+0.2cm^2,平均肺动脉嵌楔压3.47+0.24Kpa)。测定结果:第一组的肺静脉血流第1相(J相)达到高峰比第二组早,血流高峰速率第一组比第二组快(分别为47±12cm/s和28±10cm/s,P<0.01)。肺静脉血流舒张相(K相)在第一组贯穿整个舒张期,舒张末血流最高速率降至34±12cm/s,但第二组未测到K相。心房收缩时,第1组有13例(59%)和第二组全部病例均测到明显的血液逆流入肺静脉。因此,肺静脉血流方式和血流速率可以表明二尖辨狭窄和肺动脉高压的严重程度。 Twenty two patients with mild to moderate rheumatic mitral stenosis RMS (12 women,10 men,mean age was 39±12. 6 years,mean mitral valve area was 1. 2±0. 3 cm^2,mean pulmonary artery wedge pressure was 2. 93±0. 33 KPa), eighteen patients with severe RMS (10 women,8 men,mean age was 41±14. 2 years,mean mitral valve area was 0. 7±0. 2cm^2,mean pulmonary artery wedge pressure was 3. 47±0. 24 KPa) were included in this study. Pulse Doppler two-dimensional echocardiography (Toshiba B-25 mode,Japan)was used to determine pulmonary venous flow (PVF) velocity and pattern by Keren's method. In mild and moderate group,the first phase (J) peaked earlier than in severe RMS group,and the peak velocity was 47±12cm/s vs 28±10 cm/s,it was faster in the former group than in the latter group (p<0. 01);the diastolic (K) phase was throughout to the end of diastole with a peak velocity of 32±15cm/s in mild to moderate RMS group. However, the K phase can not be detected in any patient with severe RMS. During atrium contraction,marked retrograde flow into pulmonary veins was determined in 13 patients(59%) with mild RMS, and in all patients with severe RMS (p<0. 01). In conclusion,the pattern and velocity of PVF may indicate the variety of mitral stenosis and pulmonary hypertension.
作者 杨奇
出处 《泸州医学院学报》 1991年第4期303-306,共4页 Journal of Luzhou Medical College
关键词 风湿性心脏病 超声心动图 肺静脉 Pulmonary venous flow Doppler two-dimensional echocardiography rheumatic mitral stenosis
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