Houston A B, Lim M K, Doig W B, Gnanapragasam J, Coleman E N, Jamieson M P, Pollock J C
Department of Cardiology, Royal Hospital for Sick Children, Glasgow.
Br Heart J. 1989 Oct;62(4):284-90. doi: 10.1136/hrt.62.4.284.
The Doppler spectral pattern of flow through the ductus arteriosus was studied in 117 patients. In 37 who underwent catheterisation, Doppler records and aortic and pulmonary artery pressure were available (21 simultaneously with two catheters) for review while the others had surgical ligation of the duct on the basis of the results of non-invasive tests. Four flow patterns were obtained: (a) continuous flow, maximum velocity in late systole with gradual fall throughout diastole; (b) continuous flow, high systolic flow with rapid fall to a very low early diastolic velocity maintained throughout diastole; (c) continuous low velocity, maximum in late diastole; and (d) bidirectional flow. Flow pattern (a) was associated with normal or slightly raised pulmonary artery pressure; (b) with raised pulmonary artery pressure; and (c) and (d) with pulmonary artery pressure at systemic values. Comparison of the Doppler and measured pressure differences between the great arteries was reasonably good for peak values but poor for the trough readings. Doppler ultrasound clearly showed ductal flow; the flow pattern gave an indication of the pulmonary artery pressure, but pressure measurement by application of the Bernoulli equation to the flow velocities cannot yet be regarded as reliable.
对117例患者的动脉导管血流的多普勒频谱图进行了研究。在37例行心导管检查的患者中，可获得多普勒记录以及主动脉和肺动脉压力（其中21例同时使用两根导管进行测量）以供回顾分析，而其他患者则根据无创检查结果接受了动脉导管结扎手术。获得了四种血流模式：(a) 持续血流，收缩期末速度最大，整个舒张期逐渐下降；(b) 持续血流，收缩期血流速度高，迅速下降至极低的舒张早期速度，并在整个舒张期维持；(c) 持续低速度血流，舒张期末速度最大；以及(d) 双向血流。血流模式(a) 与肺动脉压力正常或略升高相关；(b) 与肺动脉压力升高相关；(c) 和(d) 与肺动脉压力达到体循环水平相关。多普勒测量值与大动脉之间实测压力差的峰值比较结果较为良好，但谷值读数的比较结果较差。多普勒超声能够清晰显示动脉导管血流；血流模式可提示肺动脉压力，但通过将伯努利方程应用于血流速度来测量压力，目前仍不能视为可靠方法。
