CAJ | 학술논문

目的：使用超声心动图研究不同程度肺动脉收缩压时,冠状静脉窦构型及血流动力学参数的变化特点。方法应用经胸超声心动图对病例组及对照组冠状静脉窦进行探测,在 M型超声心动图上测量其收缩末期最大内径(CSSD)、舒张早期内径(CSDD)、心房收缩期内径(CSAD)；使用频谱多普勒超声测量收缩期最大流速(CSSVmax)、舒张早期最大流速(CSDVmax)、心房收缩期最大流速(CSAVmax)、速度时间积分(VTIS、VTID、VTIA)；使用 xPlane多平面成像技术获得与 M型超声相同取样线上冠状静脉窦短轴图像,使用轨迹法测量与 M型超声相同时相时冠状静脉窦面积 xCSSA、xCSDA、xCSAA,计算 x每搏回心血量及每分回心血流量(xQnet)；对各项指标进行统计学分析。结果冠状静脉窦内径及横截面积与对照组比较,病例组1冠状静脉窦内径及横截面积增加,但无统计学意义,病例组2、病例组3冠状静脉窦内径及横截面积显著增大(P<0.05)。与对照组比较,各病例组的CSSVmax、CSDVmax均显著下降(P<0.05)；与对照组比较,病例组1、病例组2 CSAVmax无显著变化,病例组3 CSAVmax明显升高(P<0.05)。与对照组比较,各病例组的 VTIS及病例组2、病例组3 VTID明显减小(P<0.05),病例组2、病例组3 VTIA逐渐增加(P<0.05)。结论随着肺动脉收缩压不断增加,冠状静脉窦发生内径增宽、横截面积增大、正向血液回流速度减慢等重构性、适应性改变。
목적：사용초성심동도연구불동정도폐동맥수축압시,관상정맥두구형급혈류동역학삼수적변화특점。방법응용경흉초성심동도대병례조급대조조관상정맥두진행탐측,재 M형초성심동도상측량기수축말기최대내경(CSSD)、서장조기내경(CSDD)、심방수축기내경(CSAD)；사용빈보다보륵초성측량수축기최대류속(CSSVmax)、서장조기최대류속(CSDVmax)、심방수축기최대류속(CSAVmax)、속도시간적분(VTIS、VTID、VTIA)；사용 xPlane다평면성상기술획득여 M형초성상동취양선상관상정맥두단축도상,사용궤적법측량여 M형초성상동시상시관상정맥두면적 xCSSA、xCSDA、xCSAA,계산 x매박회심혈량급매분회심혈류량(xQnet)；대각항지표진행통계학분석。결과관상정맥두내경급횡절면적여대조조비교,병례조1관상정맥두내경급횡절면적증가,단무통계학의의,병례조2、병례조3관상정맥두내경급횡절면적현저증대(P<0.05)。여대조조비교,각병례조적CSSVmax、CSDVmax균현저하강(P<0.05)；여대조조비교,병례조1、병례조2 CSAVmax무현저변화,병례조3 CSAVmax명현승고(P<0.05)。여대조조비교,각병례조적 VTIS급병례조2、병례조3 VTID명현감소(P<0.05),병례조2、병례조3 VTIA축점증가(P<0.05)。결론수착폐동맥수축압불단증가,관상정맥두발생내경증관、횡절면적증대、정향혈액회류속도감만등중구성、괄응성개변。
Objective To research the changes of the coronary sinus(CS)configuration and hemodynamic parameters in patients with varying pulmonary artery systolic pressure.Methods the The coronary sinus in both the case group and the control group were sur-veyed by transthoracic echocardiography.Systolic internal diameter (CSSD),early diastolic internal diameter (CSDD),atrial systolic internal diameter (CSAD)of the coronary sinus were measured by M mode echocardiography.The systolic peak flow velocity (CSS-Vmax),early diastolic peak flow velocity (CSDVmax),peak flow velocity at atrial contraction (CSAVmax),and respective flow veloci-ty time integral (VTIS,VTID,VTIA)by PW were measured.Obtaining short axis images of the coronary sinus with the same sampling line as M mode echocardiography by xPlane multi planar imaging techniques,the coronary sinus area with the same phase as the M mode ultrasound (xCSSA,xCSDA,xCSAA)through drawing the trajectory of the coronary sinus were calculated.Then the net blood flow volume once and perminute (xQnet)were computed.Statistical analysis was performed on the indicators.Results Com-pared with control group,the coronary sinus diameter and cross sectional area increased significantly in case group 2 and case group 3 (P<0.05).The CSSVmax and CSDVmax decreased significantly in al case groups(P<0.05).The CSAVmax increased significantly in case group 3(P<0.05).VTIS in al case groups and VTID in case group 2 and case group 3 reduced significantly(P<0.05).VTIA increased gradual y in case group 2 and 3(P<0.05).There was no significant difference in the net blood flow volume once and perminute between case groups and control group.Conclusion With increasing of pulmonary artery systolic pressure,the changes of reconfigurability and adaptability in coronary sinus occured,which included the heighten of diameter and cross sectional area,and the reduction of forward flow velocity.