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目的 :通过对冠心病 (CHD)左心功能不全患者的肺静脉血流频谱的研究探索肺静脉血流频谱在CHD左心功能评定中的意义。方法 :应用脉冲多普勒技术对 132例左心功能Ⅰ～Ⅳ级的CHD患者及 90例健康人 (正常对照组 )进行了肺静脉血流频谱各项参数的测定并进行对照研究。结果 :与正常对照组相比CHD患者的肺静脉血流频谱D波的最大流速 (Dp)、S波最大流速 (Sp) /Dp及二尖瓣血流频谱的E峰的最大流速 (E)、A峰的最大流速 (A)在Ⅰ、Ⅱ、Ⅲ级心功能出现异常 (P <0 .0 5～ 0 .0 1) ,肺静脉血流频谱S波持续时间 (ST)及二尖瓣血流E/A在Ⅰ、Ⅱ、Ⅲ、Ⅳ级心功能均出现异常 (P <0 .0 5～ 0 .0 0 1) ,S波的速度和时间积分 (Si)、A波的速度和时间积分 (Ai)在Ⅲ、Ⅳ级心功能时出现异常 ,A波持续时间 (AT)在Ⅲ级心功能时出现异常 (P <0 .0 5 )。Sp、肺静脉的收缩期积分 (SF)在Ⅳ级心功能时才出现异常 (P <0 .0 1)。结论 :CHD患者舒张功能受损早于收缩功能 ,一旦出现收缩性心功能不全 ,临床上均为混合型左心功能不全。如果已经存在严重左心收缩功能不全的CHD患者肺静脉血流频谱Dp、D波的速度和时间积分 (Di)、AT及二尖瓣血流频谱E/A正常化说明是左心舒张功能严重受损的一种假性正常化。肺静脉血流频谱Dp、ST、Sp/Dp为CHD患者早期?
OBJECTIVE: To explore the significance of pulmonary venous flow in the evaluation of left ventricular function in patients with left ventricular dysfunction in patients with coronary heart disease (CHD). Methods: The parameters of pulmonary venous blood flow spectrum were measured in 132 CHD patients with left ventricular function Ⅰ ~ Ⅳ and 90 healthy controls (normal control group) by pulsed Doppler technique. Results: Compared with the normal control group, the maximal flow velocity (Dp), maximal S wave velocity (Sp) / Dp, and maximal flow velocity (E) of E wave in mitral flow spectrum of pulmonary venous flow in patients with CHD, The maximal flow velocity (A) of peak A was abnormal in grade Ⅰ, Ⅱ and Ⅲ (P <0.05 ~ 0.01), the duration of S wave in pulmonary venous flow spectrum (ST) and mitral valve flow The cardiac function of E / A in grade Ⅰ, Ⅱ, Ⅲ, Ⅳ were abnormal (P <0.05-0.010), S wave velocity and time integral (Si), A wave velocity and time integral (Ai) were abnormal in Ⅲ, Ⅳ grade heart function, and abnormality of A wave duration (AT) in Ⅲ grade heart function (P <0.05). Sp, pulmonary venous systolic integral (SF) in grade IV cardiac function abnormalities (P <0.01). Conclusion: Diastolic dysfunction is earlier than that of systolic dysfunction in patients with CHD. Once systolic cardiac insufficiency occurs, it is clinically mixed with left ventricular dysfunction. If the pulmonary venous flow spectrum Dp, D wave velocity and time integral (Di), CHD and mitral flow E / A normalization have been present in patients with severe left ventricular systolic dysfunction in CHD, the left ventricular diastolic function is severely affected by A pseudo-normalization of damage. Pulmonary venous blood flow spectrum Dp, ST, Sp / Dp for CHD early?