目的采用超声成像技术与生物力学方法相结合的方法,对肺动脉高压(PH)进行了肺动脉(PA)的超声生物力学研究,试将PH患者肺动脉血管的生物力学性质参数用于临床评估PH。方法选择先天性心脏病室间隔缺损并肺动脉高压患者,同步记录肺动脉压力与肺动脉二维图像,从PA收缩加压与扩张开始点到PA达到压力或扩展最大程度时点,界定为10个测量时点、9个递增步骤,分别测量每个时点的PA内径值及收缩压数值及其递增量,然后使用血管生物力学数学模型分析其肺动脉应力-应变关系。结果随着PA压力的不断上升,PA血管内径的扩展性也逐渐受限,尤其是阻力型PH组的PA内径扩张明显受限制,阻力型PH组的肺动脉物质常数a值和b值的各个参数显著减小(P<0.001),表明肺动脉物质常数a值和b值在鉴别阻力型PH方面具有一定的预测作用。结论肺动脉超声生物力学方法在评估与选择先天性心脏病合并PH患者手术适应证方面具有一定的参考作用。

Objective The pulmonary artery (PA) in patients with pulmonary hypertension (PH) was investigated by combination of ultrasound with biomechanical method. The present article is to apply mechanical parameters of PA on evaluation of properties of PH clinically. Methods Patients with ventricular septal defect with PH were selected and all cases were underwent interventional test of right heart catheterization. PA pressure and dimension of two-dimensional images were recorded, measuring in 10 points within systole. The systolic increment of both pressure and dimension of PA were calculated. The data of PA pressure and dimension were input into constitutive equations for biomechanical measurement to calculate stress-strain relation in PA. Results With increase of pulmonary pressure, the enlargement of PA dimensions was limited, especially in the high pulmonary vascular resistance subgroup of PH. Both of the constants a and b decreased at the same time significantly (P<0.001) in the subgroup, which showed the predictive value for property of PH. Conclusion Ultrasonic and biomechanical method of PA would be useful in predicting property and pathological process of PH, which would provide a new way in selection of surgical treatment for congenital heart disease with PH potentially.

昆明市重点实验室基金(2000-01)