房间隔缺损患者行经封堵术后右心室容量及血浆心钠素的变化  

Changes in Right Ventricular Volume and Plasma Atrial Natriuretic Peptide Level During Transcatheter Closure of Atrial Septal Defect

作　　者：丁建东[1] 马根山[1] 张晓黎[1] 杨荣[2] 刘标[2] 陆凤翔[2] 

机构地区：[1]东南大学附属中大医院心内科,南京210009 [2]南京医科大学第一附属医院

出　　处：《微循环学杂志》2007年第3期53-54,57,共3页Chinese Journal of Microcirculation

摘　　要：目的:观察房间隔缺损(ASD)封堵术后右心室容量及血浆心钠素(ANP)的变化。方法:对23例成功行经导管ASD封堵术的患者,分别于封堵术前、术后3天取静脉血,采用放射免疫法测定血浆ANP浓度;并于术前、术后3天行心脏三维超声心动图检查,测量右心室腔容量;并对ANP与肺动脉压(PAP)、右心室腔容量、右室射血分数进行相关分析。结果:ASD封堵术后3天血浆ANP浓度较术前明显降低(101.89±35.80ng/Lvs153.46±74.55ng/L,P<0.01);封堵术后3天右心室容量较术前明显缩小,差异有统计学意义(P<0.05),相关分析显示:ASD患者血浆ANP浓度与PAP(r=0.74)、右心室舒张末期容量(r=0.50)、收缩末期容量(r=0.50)分别呈正相关(P均<0.05)、与右室射血分数呈负相关(r=-0.38,P<0.05)。结论:ASD封堵术后血浆心钠素浓度明显降低,右心室腔明显缩小。Objective:To investigate the changes in right ventricular volume and plasma atrial natriuretic peptide(ANP)level in patients with atrial septal defect(ASD)during transcatheter closure of defects.Method:Plasma ANP levels and transthoracic three-dimensional echocardiography(3DE)measurements were performed in 23 patients with ASD before closure,and at 3 days after closure.Pearson correlation analyses were done among ANP and pulmonary artery pressure(PAP),right ventricular volume,right ventricular ejection fraction.Results:Plasma ANP levels decreased significantly at 3 days after closure(101.89±35.80 ng/L vs 153.46±74.55 ng/L,P< 0.01)compared with it before closure.After transcatheter closure of ASD,the RVEDV and RVESV decreased significantly(P <0.05).By pearson correlations,plasma ANP level positively correlated significantly with PAP(r=0.74,P< 0.05)and right ventricular end-diastolic volume(r=0.50,P< 0.05)and end-systolic volume(r=0.50,P< 0.05)and negatively correlated with right ventricular ejection fraction(r=-0.38,P< 0.05).Conclusion:After transcatheter closure,the plasma ANP level and right ventricular volume significantly decreased.

关 键 词：血浆心钠素 右心室容量 房间隔缺损 封堵术后 充血性心力衰竭 Peptide 左向右分流 房性心律失常 

分 类 号：R512.6[医药卫生—内科学]