超声心动图评价成人房间隔缺损封堵术后心脏结构和功能的变化  

Changes in cardiac morphology and function after successful transcatheter closure of atrial septal defect in adults

作　　者：申俊君[1] 黄新胜[1] 付明[1] 

机构地区：[1]广东省人民医院广东省医学科学院广东省心血管病研究所心内科,广州510080

出　　处：《岭南心血管病杂志》2010年第1期37-40,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨超声心动图评价成人房间隔缺损(atrial septal defects,ASD)介入封堵术后心脏形态和功能变化。方法经超声心动图和心电图检查确诊为ASD并成功施行ASD封堵术的患者74例,年龄(35.63±12.74)岁,ASD直径为(16.29±5.11)mm。于封堵器堵闭术后24h、1个月、3个月、6个月和12个月进行经胸超声心动图追踪测量主动脉内径、左心室舒张末内径、左心室收缩末内径和右心室前后径,肺动脉内径和肺动脉瓣血流速度,右心房和右心室的上下径、主动脉瓣口血流速度、二尖瓣口血流速度、三尖瓣口血流速度和左心室射血分数,同时测量封堵器的直径和长度,并进行统计学分析。结果术后24h与术前相比,右心房内径、右心室内径、肺动脉内径、三尖瓣口血流速度和肺动脉瓣口血流速度均显著减少(P<0.01);左心房内径、左心室内径、主动脉内径、二尖瓣口血流速度和主动脉瓣口血流速度均显著增加(P<0.05);左心室射血分数无明显变化。房室大小和血流速度在术后24h内变化明显,在术后1个月后的随访中逐渐趋于稳定。结论封堵器介入封堵ASD,既纠正了解剖畸形,又改善了左心和右心系统的几何结构。Objectives To evaluate the changes in cardiac morphology and function after transcatheter closure of atrial septal defect （ASD）by echocardiography in adults. Methods We measured and analyzed aortic dimension,left ventricular diastole internal diameter,left ventricular systole internal diameter,right ventricular anteroposterior dimension,pulmonary artery internal diameter,pulmonary valve blood flow rate,right atrium internal diameter,right ventricular up-down diameter,aortic valve blood flow velocity,mitral orifice blood flow velocity,tricuspid orifice blood flow velocity,left ventricular ejection fraction of the 74 patients with secundum-type ASD aged （35.63±12.74）years. The patients underwent echocardiographic examination before and 24 hours after transcatheter closure and during 1 month,3 months and 6 months follow-up. Diameter and length of occluder were also measured and analyzed. Results The diameter of right atrium,right ventricle,pulmonary artery and the blood flow velocity at tricuspid orifice,pulmonary valve decreased significantly 24 hours after the procedure（P〈0.01）. The diameter of left atrium,left ventricle,aorta and the blood flow velocity at mitral orifice,aortic valve increased significantly 24 hours after the procedure （P〈0.05）. No significant difference was found in left ventriculus ejection fraction during the 1 year follow-up. The cardiac size appeared to remain relatively stable one month after the procedure. Conclusions Successful transcatheter closure of ASD not only remove the shunt of atrial level,but also reconstruct right heart and left ventricle geometry significantly.

关 键 词：房间隔缺损 超声心动描记术 封堵术 

分 类 号：R541.1[医药卫生—心血管疾病]