摘要
目的探讨肺动脉高压(PAH)患者上腔静脉(SVC)血流频谱变化的特点。方法心脏介入手术和心脏外科手术患者45例,男26例,女19例,平均年龄(29±21.5)岁,右心导管检测肺动脉收缩压。按照肺动脉收缩压(PASP)分为肺动脉压正常值对照组(PASP<30mmHg,n=8)、轻度肺动脉高压组(30mmHg≤PASP<50mmHg,n=18)、中度肺动脉高压组(50mmHg≤PASP<75mmHg,n=13)、重度肺动脉高压组(PASP≥75mmHg,n=6)。同时采用彩色多普勒超声仪经右侧锁骨上窝探测上腔静脉,记录平静呼吸时上腔静脉的频谱曲线,测量同一呼吸周期中频谱曲线各波峰值及速度时间积分(VTI),计算其呼吸变化率。结果肺动脉压正常对照组上腔静脉血流频谱,收缩期S波、舒张期D波随呼吸波动明显。与肺动脉压正常对照组比较,轻度肺动脉高压组上腔静脉血流频谱S波、D波振幅无显著性差异(P>0.05)。中、重度肺动脉高压组上腔静脉血流频谱S波、D波随呼吸变化振幅减低,而离心方向的室缩波VR、房缩波AR波振幅增高(P<0.05),部分患者频谱形态发生变化。结论上腔静脉血流频谱随呼吸变化是评价肺动脉压力的有效指标,可为肺动脉高压的临床诊断提供无创血流动力学指标。
Objective To discuss the spectral characteristics of the superior vena cava （SVA） in patients with pulmonary artery hypertension （PAH）. Methods Forty-five patients consisted of 26 male and 19 female under went percutaneous intervention （PCI） or cardiac surgery were choosen. The mean age of the patients was （29±21.5） years old. Pulmonary arterial systolic pressure （PASP） was measured with right heart catheter. According to PASP, the patients were divided into four groups including control group （PASP〈30 mmHg, n=8）, mild PAH group （30 mmHg≤PASP〈50 mmHg, n=18）, moderate PAH group （50 mmHg≤PASP〈75 mmHg, n=13）, severe PAH group （PASP≥75 mmHg, n=6）. All patients were examined with echocardiography. Placed in the right supraclavicular fossa to observe the SVC. The flow spectral pattern of superior vena cava was recorded. The peak velocity and the velocity-time integral （VTI） of each spectral pattern was measured. The ratio of respiratory changes was computed. Results In control group, the systole wave （S） and the diastole wave （D） fluctuated obviously because of the respiration. Compared to the control group, the amplitudes of S wave and D wave had no significant difference （P〉0.05） in mild PAH group. But in both moderate PAH group and severe PAH group, the amplitudes of S wave and D wave reduced, the amplitudes of AR wave and VR were increased. In addition, the shape of the flow spectral pattern of some patients changed. Conclusion The variation of the spectral pattern of superior vena cava with respiration is a valid method to estimate PAP and it can provide evidence of hemodynamics for clinical noninvasive diagnosis of PAH.
出处
《中国医学影像技术》
CSCD
北大核心
2008年第2期224-227,共4页
Chinese Journal of Medical Imaging Technology
关键词
超声心动描记术
肺动脉高压
上腔静脉
心导管测定
Echocardiography
Pulmonary artery hypertension
Superior vena cava
Cardiac catheter
