彩色多普勒过返流口宽度估测二尖瓣返流的程度(1)
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[摘要] 目的：探讨彩色多普勒过返流口宽度在估测二尖瓣返流程度中的作用。方法：对30例二尖瓣返流患者，用彩色多普勒测返流束宽度、长度、面积及瞬间返流容积与有效返流口面积，比较轻度与中度及中度与重度二尖瓣返流的彩色多普勒各返流参数。结果：彩色多普勒过返流口宽度：轻度返流(2.57±0.40) mm，中度返流(3.23±0.36) mm，重度返流(5.52±1.10) mm；组间差异显著(P<0.01～0.001)。返流束宽度、长度、面积及瞬间返流容积与有效返流口面积的相关系数分别为0.85(P<0.001)，0.48(P<0.01)，0.69(P<0.001)，0.69(P<0.001)。结论：彩色多普勒过返流口宽度受血流动力学影响小，能够更准确地判断二尖瓣返流的程度。
[关键词] 二尖瓣返流；彩色多普勒过反流口
[中图分类号]R445.1 [文献标识码]B [文章编号]1673-7210(2008)11(b)-059-02
Evaluation of mitral regurgitation grading by color Doppler vena contracta
SUN Feng-lan, YU Yan, DONG Xue-li
(The Branch Courts of Traditional Chinese and Western Medicine of the Affiliated Hospital of Liaoning TCM University, Shenyang 110101, China)
[Abstract] Objective: To explore the roles of color Doppler vena contracta in the evaluation of mitral regurgitation grading. Methods: 30 cases of mitral regurgitation patients were studied by color Doppler to detect the vena contracta, jet length, jet area and instantaneous jet volume, then to compare the parameters between mild and moderate patients, and between moderate and severe mitral. Results: Mitral regurgitation in mild was (2.57±0.40) mm, in moderate was(3.23±0.36) mm, in severe mitral was (5.52±1.10) mm. There was a significant difference between each group (P<0.01～0.001).The correlation coefficient between color Doppler vena contracta, jet length, jet area, instantaneous jet volume and effective mitral orifice area were 0.85(P<0.001), 0.48(P<0.01), 0.69(P<0.001), 0.69(P<0.001) respectively. Conclusion: Color Doppler vena contracta is less affected by hemodynamics and can more accurately estimate the jet size of mitral regurgitation grading.
[Key words] Mitral regurgitation; Doppler vena contracta
二尖瓣返流(MR)是一种十分常见的心瓣膜疾病，在自然人群中的发病率为4%~6%。目前许多研究发现严重的MR可导致较高的死亡率、致残率，而且随着返流程度的加重，预后逐渐变差，因此对MR的准确定量评价直接关系到患者的预后，虽然彩色多普勒返流长度、面积及瞬间返流容积在一定程度上可以反映返流量，但这些参数却受诸如压力阶差、心房顺应性、返流方向及仪器条件的影响[1]。本研究对彩色多普勒过返流口宽度判断MR的价值进行了研究，并与上述参数进行了对比，现报道如下：
1 资料与方法
1.1 研究对象
30例MR患者，无明显二尖瓣狭窄及主动脉病变。男8例，女22例。年龄15～72岁，平均41.8岁。其中，风湿性心脏病17例，扩张型心肌病9例，冠心病2例，先心病1例及二尖瓣脱垂1例。
1.2 方法与仪器
1.2.1 仪器 HDI 5000彩色多普勒超声诊断仪，探头频率2～4 MHz。
1.2.2 方法①返流束及过瓣宽度测量：心尖四腔切面记录最大二尖瓣返流束，测量其长度、面积及瞬间返流容积 ......
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