超声心动图与X线造影测量动脉导管未闭的对比研究  

Comparing study of echocardiography and X-ray angiography on measurement of patent ductus arteriosus

作　　者：周建华[1] 黄云洲[1] 陈元禄[1] 张宏艳[2] 李冬蓓[1] 任书堂[1] 龙进[1] 

机构地区：[1]泰达国际心血管病医院超声科,天津300457 [2]泰达国际心血管病医院儿内科,天津300457

出　　处：《中华超声影像学杂志》2015年第1期11-15,共5页Chinese Journal of Ultrasonography

摘　　要：目的应用超声心动图测量动脉导管未闭（PDA），并与x线血管造影（XA）测值进行比较，分析超声心动图与XA测量PDA的相关性，探索超声心动图在筛选适合封堵术的PDA大小方面的价值。方法选择拟行PDA封堵术的患者141例行超声心动图及XA检查，分别在超声心动图胸骨旁大动脉短轴切面（PSSA）、胸骨上窝降主动脉长轴切面（SSLA）及XA左侧位投影图像上，测量动脉导管未闭长度（PDAL）、主动脉端内径（PDADao）及肺动脉端内径（PDADpa），应用超声心动图测量并计算与PDA有关的左室舒张末内径指数（LVEDDI）、主肺动脉内径指数（MPADI），PDA分流压差（AP）及肺动脉收缩压指数（PASPI）。分别对超声心动图两切面和XA测得的同一参数进行比较并分析其相关性，研究超声心动图测量的其他参数与PDA肺动脉端内径指数（PDADIpa）的相关性。结果①PDA测值的差异：超声心动图两切面测量PDA差异具有统计学意义（P〈O．05）；除SSLA测量PDADao与XA测值差异无统计学意义（P〉0．05）外，其余超声心动图测值与xA测值差异均具有统计学意义（均P〈0．05）；②相关性分析：PSSA、SSLA测值均与XA呈正相关（均P〈O．01），其中SSLA测量PDAL和PDADao，PSSA测量PDADpa与xA的相关性更好（r值分别为0．92、O．87和0．91，均P〈0．01）；LVEDDI，MPADI及PASPI均与PDADIpa呈正相关（均P〈0．01），其中LVEDDI和MPADI与PDADIpa-PSSA相关性更好（r值分别为0．76和0．72，均P〈0．01），而PASPI与PDADlpa—XA的相关性更好（r：0．70，P〈O．01）；PASP与AP呈负相关（r=-0．79，P〈0．01）。结论超声心动图在不同切面测量PDA大小具有差异性，在PSSA测量PDADpa及在SSLA测量PDAL和PDADao更接近于XA。综合应用超声心动图多切面可更准确地测量PDA大小并在辅助指导PDA封堵治疗方面发挥重要作用。Objective To measure the sizes of patent ductus arteriosus （PDA） by echocardiography, compare the results with those by X-ray angiography（XA）, to analysis the correlation of measurements between echocardiography and XA, to explore the value of echocardiography on screening the size of PDA suitable for transcatheter occlusion. Methods One hundred and forty-one participants was included. The parameters of PDA including the length of PDA （PDAL）, the aortic side diameter （PDADao） and the pulmonary side diameter of PDA（PDADpa） were measured from the parasternal great artery short-axis view （PSSA） and the suprasternal descending aorta long-axis view（SSLA） of echocardiography and left lateral projection of XA, and the other parameters such as the left ventriclular end-diastolic diameter index （LVEDDI）, the main pulmonary artery diameter index（MPADI）, the pressure drop of PDA shunt （AP） and the pulmonary artery systolic pressure index（PASPI） were measured by echoeardiography. The sizes of PDA from PSSA, SSLA and XA were compared, and the correlations of the sizes of PDA between echocardiography and XA, the correlations between the other parameters by echocardiography and the PDADpa index（PDADIpa） by XA（PDADIpa-XA） and PSSA（PDADIpa-PSSA） were analyzed. Results （2） The difference of the sizes of PDA：Between PSSA and SSLA had difference on mersurement of PDA（all P 〈 0.05）, except SSLA had no difference on measurement of PDADao with XA （P 〉 0.05）, others eehocardiography parameters all had difference on measurement of PDA with XA （all P 〈 0.05）. （2） Correlation：Both PSSA and SSLA had positive correlations with XA （all P 〈0.01 ）. And among these parameters,PDAL by SSLA, PDADao by SSLA and PDADpa by PSSA had better correlations with XA （r = 0.92,0.87 and {/.91, respectively, all P〈0.01 ）. LVEDDI, MPADI and PASPI had positive correlations with PDADIpa （all P 〈0.01 ）,the LVEDDI and MPADI had better correlations with PDADIpa PS

关 键 词：超声心动描记术 血管造影术 动脉导管未闭 封堵装置 

分 类 号：R540.45[医药卫生—心血管疾病]