肱动脉波强度对复杂先天性心脏病患者左心收缩功能评估的临床应用  

Clinical Application of Brachial Artery Wave Intensity in Evaluating the Left Ventricular Systolic Function of Patients with Complex Congenital Heart Disease

作　　者：丁云川[1] 陈剑[1] 尹帆[1] 王庆慧[1] 苏璇[1] 罗庆祎[1] 

机构地区：[1]昆明医科大学附属延安医院医学影像科,云南昆明650051

出　　处：《昆明医科大学学报》2013年第2期56-59,共4页Journal of Kunming Medical University

基　　金：云南省应用基础研究基金资助项目(2008CD050)

摘　　要：目的探讨外周动脉瞬时波强度在左心室几何形态异常或大动脉连接异常的复杂先天性心脏病心功能评估方面的临床应用价值.方法应用以回声跟踪技术为基础的波强度(wave intensity,W)I技术对27例单心室患儿和30例健康受检者的肱动脉进行检查,测量其瞬时波强度曲线,并自动获得W1峰(瞬时加速度波强)等参数,进行对比分析;并对右室双出口18例(其中室间隔缺损靠近主动脉的12例),完全性大动脉转位6例,矫正型大动脉转位8例共32例大动脉连接关系异常的患者进行W1的测量评估.结果单心室等复杂先天性心脏病患儿W1峰较对照组显著减低(P<0.01),W1与心室Max(dP/d)t呈显著正相关(r=0.874,P<0.01).大动脉连接关系异常的受检者W1均较健康对照组减低,差异有统计学意义(P<0.05),右室双出口中室间隔缺损靠近主动脉的患者W1峰值较右室双出口中主动脉远离室间隔的患者稍高.结论 WI可作为评价心室收缩功能的新方法,对于由于左心室几何形态异常及大动脉连接异常的复杂先天性心脏病患者左心室功能,WI技术也能对其进行较为准确的评估;能够在心脏病外科手术治疗术前、术中及术后提供真实准确的评价.Objective To explore clinical value of peripheral artery instantaneous wave intensity in the assessment of abnormal left ventricular geometry or arterial connection abnormal heart function of complex congenital heart disease. Methods We used wave intensity （WI, wave intensity） based on echo tracking technology to check the brachial artery of 27 children with single ventricle and 30 healthy subjects, and measured the instantaneous wave intensity curve, automatically obtain parameters such as WI peak （instantaneous acceleration wave） , and analyzed these parameters. We also measured and evaluated the WI of 18 cases of double outlet right ventricle （in which 12 cases of ventricular septal defect near the aorta） , 6 cases of complete transposition of great arteries, and 8 cases of corrected transposition of great arteries, in total 32 patients with abnormal connection of aorta. Results WI peak of children with single ventricle and complex congenital heart disease was significantly lower than that in the control group （P〈O.O1） , and W1 and ventrieular Max （dP/dt） had significantly positive correlation （r = 0.874, P〈0.01 ）. W1 of patients with abnormal arterial connection was significantly lower than that in healthy subjects in control group, the difference was statistically significant （P〈0.05）. W1 peak of patients with double outlet right ventricular septal defect near the aorta was slightly higher than that of patients with right ventricular double exports in aortic away from the interventricular septum. Conclusions WI can be used as a new method for evaluating the ventricular systolic function. WI technologies are also able to make more accurate assessment for left ventricular function of patients with complex congenital heart disease due to abnormal left ventricular geometry and arterial connection, and provide true and accurate evaluation for heart diseases before, during and after surgical treatments.

关 键 词：超声 瞬时波强 先天性心脏病 收缩功能 

分 类 号：R540.47[医药卫生—心血管疾病]