先天性脊柱侧凸与特发性脊柱侧凸伴发心脏异常对比:438例回顾性分析  

Comparison of congenital scoliosis and idiopathic scoliosis with cardiac abnormalities:a retrospective study of 438 patients

作　　者：谭焜月 刘春霞[1] 黄晓凤 王淑珍[1] 严霜霜 熊峰[1] TAN Kunyue;LIU Chunxia;HUANG Xiaofeng;WANG Shuzhen;YAN Shuangshuang;XIONG Feng(Department of Cardiology,The Third People's Hospital of Chengdu,Chengdu 610031,China)

机构地区：[1]成都市第三人民医院心内科,成都610000

出　　处：《中华骨与关节外科杂志》2022年第5期367-372,共6页Chinese Journal of Bone and Joint Surgery

摘　　要：目的:对比分析先天性脊柱侧凸(CS)与特发性脊柱侧凸(IS)伴发心脏异常情况。方法:回顾分析2018年1月至2021年1月收治的CS与IS患者的超声心动图及心电图结果。结果:研究共纳入438例患者,CS组164例,IS组274例。CS组伴动脉型肺动脉高压、右房增大及电轴右偏比例高于IS组,CS组平均肺动脉内径大于IS组(P<0.05)。动脉型肺动脉高压在主胸弯患者中的比例高于主腰弯患者;在早发性脊柱侧凸(EOS)中的比例高于非EOS。IS组瓣膜病发病率(28.8%∶20.1%,P=0.043)、二尖瓣对合异常发生率(9.1%∶4.3%,P=0.047)均高于CS组。CS、IS患者先天性心血管病发病率分别为11.0%和6.9%,差异无统计学意义(P=0.141)。结论:IS患者与CS患者先天性心血管病发病率相当。IS患者的瓣膜病发病率高于CS患者。CS患者的动脉型肺动脉高压及其继发的右心改变高于IS患者,且与主胸弯及EOS正相关。Objective:To compare the differences of abnormal founding of ultrasonic cardiography(UCG)and electrocardiogram(ECG)between congenital scoliosis(CS)and idiopathic scoliosis(IS)patients.Methods:UCG and ECG results of CS and IS patients from January 2018 to January 2021 were retrospectively reviewed.Results:A total of 438 patients were enrolled,including 164 CS and274 IS patients.The proportion of pulmonary arterial hypertention(PAH),right atrial enlargement and right deviation of electrical axis in CS patients were higher than those in IS patients,and the diameter of pulmonary artery in CS patients was larger than that in IS patients(P<0.05).The patients with main thoracic scoliosis had higher PAH incidence than patients with main lumbar scoliosis,and the incidence of PAH in EOS patients was higher than that in patients without EOS.The incidences of valvular disease and mitral valve displacement in IS patients were higher than those in CS patients(28.8%vs.20.1%,P=0.043;9.1%vs.4.23%,P=0.047).The incidence of congenital heart disease was 11.0%in CS patients and 6.9%in IS patients(P=0.141).Conclusions:There is no significant difference in the incidence of congenital heart disease between IS and CS patients.Valvular abnormalities are more common in IS patient.The increase of PAH and secondary right heart changes in CS patients are more obvious than IS patients,and the increase of PAH is positively related to main thoracic scoliosis and EOS.

关 键 词：先天性脊柱侧凸 特发性脊柱侧凸 超声心动图 

分 类 号：R682.3[医药卫生—骨科学] R541[医药卫生—外科学]