超声心动图对二尖瓣狭窄瓣膜置换术后血流动力学改变的研究

Blood flow dynamic changes after mitral valve replacement operation in patients with mitral valve stenosis by color Doppler echocardiography

目的 应用彩色多普勒超声心动图了解二尖瓣狭窄患者接受二尖瓣置换术 (MVR)前、后血流动力学改变情况。方法 回顾性分析 37例二尖瓣狭窄患者接受MVR前、后左房内径、三尖瓣反流速率、肺动脉收缩压 (PAPS)及左室射血分数改变情况 ,并进行PAPS与二尖瓣跨瓣压差 (MVΔP)间相关性分析。结果 所有患者术后均健康存活 ,平均随访 1 5 .8个月。随访结果 :MVR后左房内径、三尖瓣反流速度及PAPS均较术前显著下降 ,而左室射血分数则较术前显著上升。PAPS与MVΔP间呈显著正相关 ,且随PAPS升高 ,PAPS与MVΔP差值亦显著升高。结论MVR能有效地改善二尖瓣狭窄血流动力学 ,PAPS与MVΔP呈正相关 ,重度肺动脉高压患者肺循环内存在二级狭窄。

Objective To study the blood flow dynamic c hanges after mitral valve replacement(MVR) operation in patients with mitral valve stenosis by color Doppler echocardiography. Methods Thirty-seven- patients with mitral stenosis after MVR operation were analyzed with color Doppler echocardiography retrospectively, the observed items including dimension of left atrium, tricuspid valve backflow velocity, pulmonary artery systolic pressure(PAPS) and left ventricular ejection fraction(LVEF).Relativity analysis was conducted between PAPS and trans-mitral valve pressure(MVΔP). Results All the patients survived healthy, the average follow-up time was 15.8- months. The follow-up data suggested that the dimension of left atrium, tricuspid valve backflow velocity and PAPS decreased significantly while LVEF increased significantly to the pre-operation. PAPS was in positive correlation with MVΔP and the difference between PAPS and MVΔP increased according to MVΔP.Conclusions MVR can ameliorate flow dynamics effectively in patients with mitral stenosis, PAPS is in positive correlation with MVΔP, senior stenosis existed within pulmonary circulation in patients with severe pulmonary hypertension.