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目的 通过观察房间隔缺损 (ASD)和风湿性二尖瓣狭窄 (MS)患者的肺静脉血流频谱 (PVFP) ,并与正常人比较 ,分析不同患者间PVFP的差异 ,探讨其临床意义。方法 42例ASD及 17例MS患者同时行经胸超声心动图 (TTE)、经食管超声心动图(TEE)检查 ,测定二尖瓣血流频谱 (MVFP)、PVFP及其相关指标 ,并与正常值对照。结果 ASD组与MS组比较 ,肺静脉收缩期前向峰速 (S)、肺静脉舒张期前向峰速 (D)、肺静脉心房收缩期负向峰速 (Ar)、肺静脉收缩期时间 (S -T)、肺静脉舒张期时间 (D -T)之间的差异有显著意义。应用心率校正公式后 ,两组之间的D -T差异显著性消失 ,S -T差异仍具显著性 (P <0 0 1) ,表明两组间D -T的差异系由心率 (HR)不同所致 ,而S -T的差异更具有临床意义。ASD组与正常人比较 ,S、D增高、S波与D波幅度比值降低 ( P <0 0 1) ;Ar、S -T、D -T两组差异无显著意义 (P >0 0 5 )。MS组与正常人比较 ,S降低、Ar增高 ,S/D波幅比值降低 (P <0 0 5 )。结论 TEE观察PVFP具有清晰 ,受干扰小等优点。ASD组与MS组的PVFP各具显著特征 ,两者之间差异有显著意义。ASD组、MS组与正常值之间差异亦有显著意义。
Objective To investigate the clinical significance of PVFP in different patients by observing pulmonary venous flow spectrum (PVFP) in patients with atrial septal defect (ASD) and rheumatic mitral stenosis (MS) and comparing with normal subjects. Methods Twenty-two ASD patients and 17 MS patients underwent transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) at the same time. Mitral flow velocity (MVFP) and PVFP were measured and compared with normal Control. Results The peak systolic velocity (S), pulmonary vasodilation anterior peak velocity (D), pulmonary ventricular systolic negative peak velocity (Ar), pulmonary venous systolic time (S-T ), Pulmonary venous diastolic time (D-T) between the significant difference. After applying the formula of heart rate correction, the difference of D-T between the two groups disappeared significantly and the difference of S-T was still significant (P <0.01), indicating that the difference of D-T between the two groups was composed of heart rate (HR) Different due to differences in S-T more clinical significance. There was no significant difference in the two groups of Ar, S-T and D-T between ASD group and normal subjects (P> 0.05) . In MS group, S decreased, Ar increased and S / D amplitude decreased (P <0.05). Conclusion TEE observed PVFP has the advantages of small interference. PVP in ASD group and MS group have significant characteristics, the difference between the two groups is significant. The difference between ASD group and MS group was also significant.