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特发性肥厚性主动脉瓣下狭窄(IHSS)的特征是左室流出道呈动力性梗阻,系由于肥厚的室间隔与二尖瓣前叶在收缩期对合而造成,梗阻程度随在室收缩力、心室容量及后负荷的大小而改变。Val-salva氏动作正压期时静脉回流减少,可使左室流出道压力阶差增加。吸入亚硝酸异戊酯导致周围血管阻力降低、心率增快、心脏指数及喷血速度增加,可加重左室流出道梗阻。酚妥拉明亦可引起周围血管阻力降低、心室收缩力增强和心率轻度增快,因此亦可用作激发左室流出道梗阻的诊断试验。本文目的是:(1)比较酚妥拉明与亚硝酸异戊酯对IHSS患者左心室流出道梗阻的作用;(2)IHSS患者在用心得
Idiopathic hypertrophic aortic stenosis (IHSS) is characterized by a dynamic obstruction of the left ventricular outflow tract, due to the hypertrophy of the interventricular septum and mitral valve anterior systolic caused by confluence, the degree of obstruction with the room Contractility, ventricular volume and the size of the load after the change. Val-salva’s action decreases during positive pressure venous return, left ventricular outflow tract pressure gradient increased. Inhalation of isoamyl nitrite leads to decreased peripheral vascular resistance, increased heart rate, increased cardiac index and spurting velocity, and increased left ventricular outflow tract obstruction. Phentolamine can also cause peripheral vascular resistance decreased, increased ventricular contractility and mild heart rate increase, it can also be used as a diagnostic test to stimulate left ventricular outflow tract obstruction. The purpose of this paper is to: (1) compare the effect of phentolamine and isoamyl nitrite on left ventricular outflow tract obstruction in IHSS patients; (2)