心脏正常值医学知识.ppt

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。,小儿心脏测量正常参考值（mm）,年龄,例数,AO,前后,AO,内径,LA,LV,LVOT,RV,RVOT,IVS,LVPW,x,S,x,S,x,S,x,S,x,S,x,S,x,S,x,S,x,S,新生,52,9.7,0.7,8.7,0.6,9.7,1.0,19.0,1.0,12.3,1.7,9.3,1.6,14.2,1.8,1.8,0.3,1.6,0.4,1月,37,11.4,1.3,10.4,1.2,11.6,1.3,23.5,1.3,13.7,1.8,9.7,2.2,17.2,1.8,2.6,0.5,2.6,0.5,4月,33,12.9,1.2,11.9,1.2,13.0,1.6,25.9,1.6,14.9,2.0,9.5,1.8,18.2,1.8,2.7,0.3,2.7,0.4,7月,40,14.1,1.0,13.1,1.1,14.8,2.1,27.8,2.1,15.6,1.8,10.6,2.2,20.1,1.9,3.3,0.4,3.3,0.4,1岁,53,15.2,1.0,14.2,1.0,16.6,2.1,29.5,2.1,16.8,2.1,10.8,2.4,20.9,1.9,3.7,0.4,3.7,0.4,2,35,16.2,0.9,15.1,0.9,17.9,2.1,30.9,2.1,18.7,2.1,11.3,2.8,19.9,2.6,3.9,0.4,3.8,0.4,3,34,18.4,1.3,15.4,1.2,17.5,2.2,30.8,2.2,17.7,2.0,11.6,2.0,20.3,2.1,3.8,0.4,3.8,0.4,4,42,20.0,1.8,16.8,1.3,17.9,2.2,31.5,2.2,19.3,2.5,11.1,1.0,20.4,3.5,4.4,0.6,4.4,0.5,5,44,20.6,1.7,17.9,1.5,19.4,1.7,32.5,1.7,20.8,1.9,12.1,1.7,21.5,3.3,4.4,0.5,4.5,0.5,6,48,21.3,1.7,19.7,1.7,1938,1.7,35.8,1.7,21.5,2.7,12.5,1.3,21.0,3.7,5.1,0.5,4.7,0.5,7,45,21.6,1.9,19.4,1.3,20.7,2.1,37.7,2.1,22.6,2.5,11.9,1.4,22.1,3.1,5.2,0.4,5.0,0.5,8,46,21.6,1.6,19.8,1.4,21.2,1.6,38.6,1.6,22.1,2.2,12.6,0.3,21.2,3.5,4.9,0.6,5.0,0.6,9,46,21.3,1.7,20.3,1.7,20.9,2.0,39.7,2.0,22.1,2.2,12.3,1.4,22.3,2.8,4.8,0.8,5.0,0.7,10,49,22.3,1.7,19.8,1.7,21.5,2.3,40.9,2.3,22.7,2.6,12.9,1.5,22.4,2.7,5.1,0.7,5.1,0.5,11,44,24.5,1.9,22.6,1.9,22.6,2.5,42.8,2.5,24.5,2.8,14.1,2.0,23.6,3.9,5.7,0.8,5.7,0.9,12,68,24.3,2.1,22.3,1.4,23.9,2.4,43.6,2.4,25.6,2.2,13.4,1.4,23.8,3.1,5.7,0.8,5.6,0.8,13,62,24.7,2.8,23.0,2.0,23.8,4.1,44.7,4.1,25.6,3.7,13.7,1.6,25.9,4.0,5.8,0.8,5.8,0.8,14,37,25.2,2.0,24.1,2.1,25.7,2.9,45.2,2.9,27.5,2.8,14.5,2.6,26.8,3.6,6.9,0.8,6.8,0.7,15,30,26.8,1.7,25.8,1.7,27.1,2.0,45.6,2.0,27.9,3.0,15.8,2.4,28.2,3.9,7.2,0.8,7.2,0.8,16,32,26.4,1.8,25.4,1.8,27.3,2.1,46.5,2.1,28.8,3.2,14.7,2.6,28.1,3.4,7.8,0.8,7.8,0.8,17-18,32,27.8,2.4,26.8,2.4,27.7,2.7,47.0,2.7,29.1,3.1,15.7,2.7,29.5,3.6,8.4,0.8,8.4,0.8,2.胸骨旁主动脉短轴切面,正常值：PA（a）17.5-22.7mm,RPA（b）10.9-14.8mm,LPA（c）11.2-14.1mm,RCA 2.58-4.46mm,LCA 2.72-4.62mm,AVA 3-4cm,2,3.二尖瓣水平短轴切面,正常值：MVA 4-6cm,2,狭窄：轻度1.5-2.5cm,2,中度1.0-1.5cm,2,重度1.0cm,2,4.心尖四腔心切面（mm）,项目,性别,上下径,左右径,LA,M,42.2-49.3,32.9-36.3,F,39.9-49.1,31.2-34.8,RA,M,40.0-45.0,31.6-37.2,F,35.5-43.7,27.8-31.6,LV,M,70.0-76.7,40.4-44.7,F,66.0-72.4,38.4-42.1,RV,M,50.6-60.0,29.1-33.1,F,49.7-57.6,25.4-29.1,5.胸骨上窝主动脉短轴切面,正常值：SVC 吸气末 6.48-11.70mm,呼气末10.30-14.30mm,6.剑下下腔静脉长轴切面,正常值：IVC 吸气末 5.58-10.70mm,呼气末12.70-17.60mm,剑下心腔切面是显示房间隔的最佳切面，对判断房缺有重要意义。,继发孔型（II孔型）ASD封堵术通常应满足：,（1）ASD,30mm(国外）36mm（国内）,（2）ASD距上腔静脉，下腔静脉及二尖瓣5mm,VSD封堵术通常应满足：,（1）左向右分流的肌部或膜部VSD30%,心肌缺血时，增厚率减低，室壁变薄。室壁运动正常：收缩期心内膜向心运动幅度5mm,室壁增厚率30%；,室壁运动减低：收缩期心内膜向心运动幅度2-4mm或较正常室壁减弱50-70%,多见于不同程度心肌缺血。,室壁运动消失：收缩期心内膜向心运动幅度Aa Sa波5cm/s,(五）心功能评估,1.左室收缩功能,正常值：LVESV：（24,10）ml/m,2,LVEDV:,（70,20）ml/m,2,SV:60-120ml EF:67%8%FS:34%5%,2.左室舒张功能,正常值：EV（二尖瓣血流舒张早期最大流速）（8616）cm/s,AV(二尖瓣血流舒张晚期最大流速）（56,13）cm/s,EV/AV（E峰与A峰比值）1.60.5,IRT（左室等容舒张期）,（9021）ms,AR（心房收缩期肺静脉返流速度）20cm/s,EDT(E峰减速时间）,（19932）ms,EF斜率（二尖瓣前叶舒张早期后移速度）80-200mm/s,3.左室质量,正常值：Murray法：70-80g,计算方法：LVMW=(Dd+PW),3,-Dd,3,x1.05,Bennett法：（14538）g,计算方法：LVMW=(Dd+2PW),3,-Dd,3,x1.05,吉冈春记法：（13035）g,计算方法：LVMW=(Dd+IVSd+PW),3,-Dd,3,x1.05,Dd：左室舒张末内径；PW：做时候比舒张末期厚度；IVSd：室间隔舒张末期厚度。,4.左室整体功能-Tei指数,左室Tei指数范围：0.39,0.10,右室Tei指数范围：0.32,0.03,注：FS（短轴缩短分数）=（Dd-Ds）/Ddx100%,SV（心搏量）=EDV-ESV,EF（射血分数）=SV/EDVx100%,左室壁节段运动与冠状动脉供血关系：左前降支（LAD,供应前壁及前间隔基底段-中间段，全部心尖段；左回,支（LCX）供应侧壁及后壁基底段-中间段；右冠状动,（RCA）供应下壁及后间隔基底-中间段,（六）肺动脉压的超声心动图估测,正常值（海平面状态下，静息时）：,PASP（肺动脉收缩压）15-30mmHg PASP=4V,TR,2,+RAP,PADP（肺动脉舒张压）5-10mmHg,PAMP（肺动脉平均压）10-20mmHg PAMP=（PASP+2PADP)/3,RAP(右房压）RA大小正常，轻度TR，约5mmHg，RA轻度增大，中度TR，约10mmHg，RA明显增大，重度TR，约15mmHg,心血管压力指标（mmHg）,项目,收缩压,舒张压,平均压,RA,4-6,-2,2,2-4,RV,15-30,2-5,LA,5-10,LV,80-130,5-10,70-95,AO,80-130,60-90,70-95,SVC,3-6,IVC,5-7,