正常成年人冠状静脉窦的超声心动图测定

Echocardiography Study of Coronary Sinus in the Normal Adults

目的 旨在研究正常成年人冠状静脉窦(CS)的超声探测方法和测定正常值及其意义.方法 120名正常成年人分为三组(每组男、女各20名):40岁以下者为组一(平均29.88±7.18岁);40～59岁者为组二(平均48.15±5.89岁);60岁及其以上者为组三(平均68.73±4.85岁).仪器:HP-500和HP-5500型(探头频率2～4MHz)彩色多普勒超声诊断仪.探查方法和指标:取胸骨旁左室长轴切面,探测CS短轴,测定CS前后径(CSSD);取心尖冠状静脉窦四腔切面,探测CS长轴,测定CS右心房开口内径(CSOD)、距CSOD一厘米处内径(CSMD)、CS长径(CSLD)和CS开口至三尖瓣环距离(CSOT).以上参数均于心室收缩末期,测量三个心动周期,取平均值.统计学处理:所有指标均以(?)±s表示,组间比较采用方差分析q检验,性别间比较采用非配对t检验,P<0.05有统计学意义.结果 各项指标测定结果如下(单位=mm):组一CSOD 7.36±1.73;CSMD5.52±1.61;CSSD3.06±0.64;CSLD30.05±5.49;CSOT7.15±1.61;组二CSOD7.44±1.29;CSMD5.85±1.11;CSSD3.30±0.65;CSLD28.99±5.49;CSOT7.53±1.77;组三CSOD8.90±1.18;CSMD7.24±1.18;CSSD3.85±0.72;CSLD30.42±5.63;CSOT8.88±2.46.统计学分析:性别间比较,各项指标间均无显著差异(P>0.05);组间比较,组三CSOD、CSMD、CSSD及CSOT均大于组一和组?

Objective To evaluate the echocardiographic method for detecting Coronary Sinus(CS) and measurement of the normal value of CS in normal adult. Methods Dividing 120 adults into three groups (20 men and women in each group respectively). Group I<40 years;Group Ⅱ 40-59 years,Group Ⅲ≥60years. HP-500 and HP-5500 color Doppler echocardiography was used. By the parasternal long axis view of the left ventricle,short axis of CS was detected and the distal inner diameter of CS(CSSD) was measured. By the apical four-chamber view of CS,long axis of CS was detected and the diameter of CS orifice in right atria (CSOD),the CS mid diameter (CSMD) at 1cm apart from CSOD,the CS length diameter (CSLD) and the distance from the CS orifice to the tricuspid valve ring (CSOT) were measured. All parameters were averaged values measured by three heart beat at endsystolic duration. Results Group I:CSOD 7. 36±1. 73mm,CSMD 5. 52±1. 61mm,CSSD 3. 06±0. 64mm,CSLD 30. 05±5. 49mm,CSOT 7. 15±1. 61mm; Group Ⅱ:CSOD 7. 44±1. 29mm,CSMD 5. 85±1. llmm, CSSD 3. 30±0. 65mm, CSLD 28. 99±5. 49mm,CSOT 7. 53±1. 77mm; Group ⅢCSOD 8. 90±1. 18mm,CSMD 7. 24±1. 18mm,CSSD 3. 85±0. 72mm,CSLD 30. 42±5. 63mm,CSOT 8. 88±2. 46mm. The differences between male and female were insignificant (P>0. 05). CSOD,CSMD,CSSD,CSOT in group I and group Ⅱ were significantly smaller than that in group Ⅲ (P<0. 01),but no obvious difference between group I and group Ⅱ (P>0. 05). Conclusion 1. Routine parasternal long axis view of the left ventricle and apical four-chamber view of CS could not detect CS clearly because of interference with strong echo of mitral valve ring. Through reducing echo gain and scanning angle of ultrasonic probe, clear ultrasonic image of CS could be obtained. 2. CSOD. CSMD,CSSD and CSOT increased with ages, the reason may be parasternal the enhanced pressure of right atrial with ages. 3. It suggtsted that the e-chocardiographic may detect CS and measured the normal value of CS, providing quantification reference index for diagnosis and therapy of interventional cardiology. There was limitation of detecting integrate CS by this method.