法洛四联症主要体-肺侧支分布及特征探讨  

Distribution and feature of major aorta pulmonary collateral arteries in tetralogy of Fallot

作　　者：杨向太[1] 崔燕海[1] 王绍荣[1] 张群[1] 唐向周[1] 谈文开[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导管室,广州510080

出　　处：《岭南心血管病杂志》2010年第3期195-198,共4页South China Journal of Cardiovascular Diseases

基　　金：广东省自然科学基金(项目编号:06020823)

摘　　要：目的总结伴有主要体-肺侧支(major aorta-pulmonary collateral arteries,MAPCAs)形成的法洛四联症(tetralogyofFallot,TOF)侧支的分布规律及特征。方法回顾性分析2007年3月至2010年3月95例合并MAPCAs的TOF患者的造影资料。记录并总结TOF的MAPCAs分布规律、数量及形态学特征。结果全组共发现MAPCAs共447支,平均4.7支/例,其中81例合并毛细小侧支血管;另外发现合并动脉导管未闭5例。其中主动脉弓发出侧支血管者33例(34.74%),共37支(8.28%);胸降主动脉上1/3有81例(85.26%),共145支(32.44%),胸降主动脉中1/3有49例(51.58%),共72支(16.11%);胸降主动脉下1/3有31例(32.63%),共41支(9.17%);腹主动脉有53例(55.79%),共84支(18.79%);头臂干有32例(33.68%),共35支(7.83%);胸廓内动脉有12例(12.63%),共15支(3.36%);左锁骨下动脉有11例(11.58%),共11支(2.46%);其他部位少见。全组有45支(10.07%)MAPCAs开口出现不同程度的狭窄;202支(45.19%)MAPCAs在进入肺脏前出现弯曲。结论 TOF合并的MAPCAs多数发自于主动脉弓、降部及其分支,以胸降主动脉中、上段最多见,其他部位亦常有MAPCAs发出,应引起重视。Objectives To investigate the distribution and characteristics of major aorta-pulmonary collateral arteries （MAPCAs） in tetralogy of Fallot （TOF）. Methods We restrospeetively analyzed the angiography data of 95 TOF patients from March 2007 to March 2010. Distribution, number and the morphological feature of MAPCAs were recorded and summarized. Results Totally 447 MAPCAs were found （mean 4.7/ease）, 81 cases with small tiny collars and 5 cases with patent ductus arteriosus among 95 cases. There were 33 cases（34.74%） with 37 MAPCAs （8.28%） at aortic arch, 81 cases （85.26%） with 145 MAPCAs （32.44%） at superior 1/3 of thoracic descending aorta,49 cases （51.58%） with 72 MAPCAs （16.11%） at middle 1/3 of thoracic descending aorta, 31 cases （33.68%） with 41 MAPCAs （9.17%） at inferior 1/3 of thoracic descending aorta, 53 cases （55.79%） with 84 MAPCAs （18.79%） at abdominal aorta, 32 cases （33.68%） with 35 MAPCAs （7.83%） at anonyma, 12 cases （12.63%） with 15 MAPCAs （3.36%） atarteria mammaria intema, 11 cases （11.58%） with 11 MAPCAs （2.46%） at left subclavian artery, respectively. Few MAPCAs origined from rare location. Fourty-five （10.07%） showed varied degrees of stenosis and 202 （45.19%） had squirm twist at proximum among 447 MAPCAs. Conclusions The MAPCAs are commonly found at aortic arch, descending aorta and major hranchs in TOF, especially the first two parts of the thoracic descending aorta. However, some MAPCAs origin from the rare location, the attention should be attached.

关 键 词：心脏缺损 先天性 法洛四联症 心血管造影 主要体-肺侧支血管 

分 类 号：R541.1[医药卫生—心血管疾病]