心导纳微分环肺导纳微分环对瓣膜病研究的探讨

Discussion about cardiac admittance difference loop orpulmonary admittance difference loop for study of the valval diseases

关键词:  心导纳微分环  肺导纳微分环  二尖瓣关闭不全  二尖瓣狭窄  主动脉瓣关闭不全  主动脉瓣狭窄

Key words:  Cardiac admittance difference loop (CADL)  Pulmonary admittance difference loop (PADL)  mitral insufficiency  mitral stenosis  aortic insufficiency  aortic stenosis

摘要:

探讨用心导纳微分环（CADL）、肺导纳微分环（PADL）诊断瓣膜病。方法：选择经彩色超声多普勒、MRI检查确诊的瓣膜病患者６０例，其中二尖瓣关闭不全、二尖瓣狭窄的患者３０例；主动脉瓣关闭不全、主动脉瓣狭窄的患者３０例，对他们进行CADL或PADL的检测。结果：６０例瓣膜病患者中有５１例的CADL或PADL环形出现不同程度的变异，变异率占８５％。其中二尖瓣关闭不全者的１５例中有１２ 例CADL的Ⅰ相面积减小，有些还出现离心支切迹，Ⅲ相面积增大，Ⅴ向左移且面积增大，环形变异率为８０％。二尖瓣狭窄者的１５例中有１４例PADL的Ⅰ相面积减小，Ⅲ、Ⅴ相面积增大，环形变异率占９３％。主动脉瓣关闭不全者的２０ 例中有１７例CADL的Ⅰ相末尾切迹明显，Ⅰ、Ⅲ相面积增大，环形变异率为８５％。主动脉瓣狭窄者的１０例中有８例CADL的Ⅰ相面积减小并出现离心支切迹或双峰，Ⅴ向左移且面积增大，环形变异率占８０％。结论：上述结果提示我们，CADL、PADL作为一种无创伤性的新兴检测技术，在瓣膜病的诊断上具有一定的临床意义和应用价值。

Abstract:

Discussion about using cardiac admittance difference loop (CADL) or Pulmonary admittance difference loop (PADL) to diagnose valval disease. Method: To select 60 valval disease patients diagnosed by Colour Ultrasound Doppler Flowmeter and Magnetic Resonance Imaging (MRI) detections, among those 30 patients suffering from mitral insufficiency and mitral stenosis, 30 patients arotic insufficiency and aortic stenosis, being engaged in CADL or PADL detection for them. Results: The CADL or PADL figures of 51 cases among 60 patients suffering from valval disease alter to different extent , altering rate accounting for 85% . 12 cases among 15 mitral insufficiency patients show such figures ,in which phase I area of CADL decreases ,some display centrifugal branch cutting marks with phase III area increasing,left shifting and increasing area of phase V. loop figure altering rate being 80%. For 14 cases of 15 mitral stenosis patients ,phase I area of PADL decreases,and phase III and V areas of PADL increase , loop figure altering rate accounting for 93%. 17 cases among 20 aortic insufficiency patients have such CADL figures ,in which there is a clear cutting mark at the end of phase I ,the areas of phase I and phase III increase, loop figure altering rate being 85% .8 cases of 10 patients suffering from aortic stenosis have such CADL figures with decreased phase I area and centrifugal branch cutting mark or double peaks ,left shifting and increasing area of phase V ,loop altering rate accounting for 80%. Conclusion: The results described above suggest that CADL or PADL,as a new nontraumatic detecting technique ,possesses certain clinical significance and application value in diagnosing valval disease.