摘要
目的应用三维超声心动图评价经皮穿刺房间隔缺损(ASD)封堵术后右心室容量和功能的变化。方法继发孔型ASD患者58例,男24例,女34例,年龄4～67岁,平均(28.9±17.1)岁,其中23例患者成功地施行了经皮穿刺ASD封堵术[男11例,女12例,年龄6～57岁,平均(25.7±13.3)岁]。与ASD患者性别、年龄相匹配的正常人32例为对照组[男18例,女14例,年龄4～45岁,平均(24.8±12.0)岁],应用HPSONOS5500超声心动图仪进行三维采集,并在TomTecEchoView4.2工作站行三维重建,测得右心室舒张末期容量(RVEDV)、收缩末期容量(RVESV),并计算右心室射血分数(RVEF)。23例行封堵术者,ASD直径(球囊测量值)为9～36(25.07±7.50)mm,均置入Amplatzer封堵器。所选封堵器直径为11～40mm。分别于术后3d、1个月、3个月复查测量RVEDV和RVESV,并计算RVEF,观察经皮穿刺ASD封堵术后右心室容量及功能的变化。结果与正常对照组相比,ASD患者RVEDV[(101.74±25.17)mLvs(59.65±15.00)mL,P<0.01]及RVESV[(56.81±16.77)mLvs(27.83±9.17)mL,P<0.01]明显增大,RVEF[(44.82±4.51)%vs(54.11±5.89)%,P<0.01]明显减低。经皮穿刺ASD封堵术后,RVEDV及RVESV较术前明显缩小,RVEF明显升高。结论ASD患者右心室容量负荷较正常人显著增加,右心室功能下降;经皮穿刺ASD封堵术既减轻了右心室的容量负荷,也改善了右心室功能。
Objective To evaluate changes of RV vohune and function in patients with ASD after transcatheter closure of ASD by three-dimensional echocardiography, Methods In 58 patients with ASD （24 men, 34 women; mean age 28.9±17.1, range 4 to 67 years）, 23 patients （11 men, 12 women; mean age 25.7±13.3, range 6 to 57 years） were diagnosed as secundtun ASD [the stretched diameters of ASD were from 9 to 36 （25.1±7.5） mm], and had successfully received Amplatzer septal occluder （ASO, the sizes of ASO ranged from 11 to 40 mm ）, 32 healthy people （18 men, 14 women; mean age 24.8±12.0, range 4 to 45） were matched interms of age and sex as the control group. Three-dimensional images were acquired by HP-SONOS 5500 cardiac scanner （Hewlett-Packard Company, Andover, Mass） and were reconstructed by Tom-Tec EchoView 4.2 （TomTec Imaging Systems, GmbH） to calculate right ventricular end-diastolic vohune （RVEDV）, right ventricular end- systolic vohane （RVESV） and right ventricular ejection fraction （RVEF）. RVEDV, RVESV and RVEF were measured at 3 days, 1 and 3 months after the procedure, Results The RVEDV and RVESV [（101.74±25.17） mL vs （59.65±15.00） mL, P〈0.01; （56.81±16.77） mL vs （27.83±9.17） mL, P〈0.01] were enlarged in patients with ASD compared with that in the control group, resulting in a remarkable decrease of the RVEF [ （44.82±4.51 ） % vs （ 54.11±5.89） %, P 〈 0.01 ]. After transcatheter closure of ASD, the RVEDV and RVESV decreased; but the RVEF increased. Conclusion The vohune load is greater and the RV function decreases in patients with ASD compared with those in the control group. Transcatheter closure of ASD not only eliminates vohune load of the right ventricle, but also improves its function.
出处
《中国介入心脏病学杂志》
2005年第5期296-298,共3页
Chinese Journal of Interventional Cardiology
