成人房间隔缺损介入治疗对右心功能的影响  

Effct of interventional therapy on right ventricular function in adult patients with atrial septal defect

作　　者：康慧元 罗建方 张曹进[1] 费洪文[1] 李贺贺[1] 

机构地区：[1]广东省心血管病研究所广东省人民医院广东省医学科学院,广州510100

出　　处：《岭南心血管病杂志》2014年第3期335-337,356,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨超声心动图技术评估成人房间隔缺损介入治疗对右心功能的影响。方法选择60例成人房间隔缺损患者设为治疗组,另外选择30名健康成人作为对照组。治疗组患者在术前、术后1 d、术后6个月通过超声心动图技术测量三尖瓣收缩期位移(TAPSE)、三尖瓣环收缩期峰值速度(S’)、右心室收缩末面积(AreaES)、右心室舒张末面积(AreaED)、右心室面积变化率(RVFAC),以及在同等条件下测出健康成人对照组的上述数据,并对两组数据进行统计分析。结果两组年龄比较,差异无统计学意义[(40.10±13.9)岁vs.(40.87±15.5)岁,P=0.849]。治疗组术前右心室收缩末面积、右心室舒张末面积、三尖瓣收缩期位移、三尖瓣环收缩期峰值速度大于对照组,差异有统计学意义[(15.28±4.30)cm2 vs.(7.27±2.41)cm2,P=0.000;(28.98±6.68)cm2 vs.(15.15±3.63)cm2,P<0.001;(2.58±0.67)cm vs.(2.25±0.45)cm,P=0.045;(16.5±0.3)cm/s vs.(14.2±2.9)cm/s,P=0.004];而RVFAC小于对照组,差异有统计学意义(47.34%±7.26%vs.52.63%±6.77%,P=0.007)。治疗组介入治疗后第1天三尖瓣收缩期位移、三尖瓣环收缩期峰值速度与治疗前比较,差异有统计学意义[(2.32±0.46)cm vs.(2.58±0.67)cm,P<0.01;(12.7±2.6)cm/s vs.(16.5±0.3)cm/s,P<0.01];术后6个月RVFAC与治疗前比较,差异才有统计学意义(50.76%±3.56%vs.47.34%±7.26%,P<0.05)。结论房间隔缺损早期已经出现右心功能受限,介入治疗后右心功能逐渐恢复至正常成人水平,超声心动图评估成人房间隔缺损右心功能需要不同指标的综合评价。Objectives To evaluate the right ventricular function in adult patients with atrial septal defect （ASD） after interventional therapy by echocardiography. Methods Sixty adult patients with ASD were in treatment group and 30 healthy adults were in control group. Tricuspid annular plane systolic excursion （TAPSE）, systolic velocity （S＇）, end-systolic area （AreaES）, end-diastolic area （AreaED） and right ventricular fractional area change （RVFAC） before and after interventional therapy and during the short-term follow-up （6 months after surgery） were measured and compared by echocardiography in both groups. Results There was no statistical difference in age between the two groups [（40.10±13.9） years vs. （40.87±15.5）years, P=0.849]. Before treatment, AreaES, AreaED, TAPSE and S＇ of treatment group were significantly larger than those of control group [ （15.28±4.30） cm^2 vs. （7.27±2.41） cm^2, P=0.000; （28.98±6.68） cm^2 vs. （15.15±3.63） cm^2, P〈0.001 ; （2.58±0.67）cm vs. （2.25±0.45）cm, P=0.045 ; （16.5±0.3） cm/s vs. （14.2±2.9）cm/s,P=0.0043, while RVFAC was significantly less than that of control group （47.34%±7.26% vs. 52.63% ±6.77%, P=0.007）. At the first day after interventional therapy, TAPSE and S＇ significantly decreased in treatment group [（2.32±0.46） cm vs. （2.58±0.67） cm, P〈0.01; （12.7±2.6） cm/s vs. （16.5±0.3） cm/s, P〈0.011, while RVFAC significantly increased 6 months post-operation （50.76%±3.56% vs. 47.34%±7.26%, P〈0.05）. Conclusions Right ventricular function occurs to be limited at the early stage of ASD, but it can gradually return to normal level after inerventional therapy. Evaluation of right ventricular function by echocardiography needs comprehensive indexes.

关 键 词：房间隔缺损 超声心动图 介入治疗 右心功能 

分 类 号：R541.1[医药卫生—心血管疾病]