肺静脉血流频谱对急性心肌梗死患者左心室舒张功能的评价

Pulmonary venous flow pattern for assessment of left ventricular diastolic function in patients with acute myocardial infarction

目的 应用彩色多普勒超声心动图研究肺静脉血流频谱评价急性心肌梗死患者左心室舒张功能的价值。方法 急性前壁心肌梗死患者 3 0例 ,同时选择 3 0例正常人作为对照组 ,用彩色多普勒超声心动图检测肺静脉血流频谱指标 :收缩期肺静脉前向峰值流速 (S)、舒张早期肺静脉前向峰值流速 (D)及其比值S/D、心房收缩期肺静脉逆向峰值流速 (PA)、PA波间期(PAd) ,与所检测的二尖瓣血流频谱指标 :舒张早期峰值流速 (E)、舒张晚期峰值流速 (A)及其比值E/A、E波减速时间 (DT)、A波间期 (Ad)比较 ,将结果进行对比分析。结果 急性心肌梗死组PA、PAd -Ad较正常对照组显著增大 ,增大幅度与左心室舒张功能明显相关。结论 肺静脉血流频谱指标能鉴别二尖瓣血流频谱“伪正常化” 。

Objective To evaluate the left ventricular diastolic function by measuring the pulmonary venous flow pattern in patients with acute myocardial infarction (AMI). Methods Thirty patients with AMI and 30 normal control group were examined by color Doppler echocardiography to determine pulmonary venous flow pattern. The parameters of pulmonary venous flow pattern examined included S, D, S/D, PA and PAd. The parameters of mitral flow pattern examined included E, A, E/A, DT and Ad. Results The PA and PAd-Ad of AMI were obviously greater than those of normal control group. The increasing degree of PA and PAd-Ad was significantly correlated with left ventricular diastolic function. Conclusion Pulmonary venous flow pattern plays an important role in differentiating pseudonormalized mitral flow pattern. Combining with mitral flow pattern to assess left ventricular diastolic function,pulmonary venous flow pattern is more acute and reliable than only using mitral flow pattern.