超声心动图观察PDA并肺动脉高压封堵术后心脏重构和肺动脉压变化  

Observation of Ventricular Remodeling and Pulmonary Arterial Pressure Changing by Echocardiography after Trans-catheter Occlusion of Patent Ductus-arteriosus with Pulmonary Hypertension

作　　者：李煜华[1] 陈志刚[1] 龙滨[1] 何俊[1] 王海燕[1] 赵燕[1] 

机构地区：[1]解放军452医院特诊科,成都市610061

出　　处：《中国超声医学杂志》2016年第3期220-222,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的超声心动图评价动脉导管未闭(PDA)合并中、重度肺动脉高压(PH)患者封堵术后心脏形态结构和肺动脉压的变化。方法将28例成功实施PDA封堵术患者分为中度PH组(A组)和重度PH组(B组)。B组分为左室增大组(B1组)和左室大小正常组(B2组)。术前、术后24h、5d、1、3、6、12个月行超声心动图检查,测量心脏各房室大小及肺动脉收缩压(SPAP)。结果 (1)封堵术后12个月A组肺动脉压SPAP下降最快。B1组肺动脉压缓慢下降,B2组下降程度小于B1组。(2)A组、B1组术前左心增大,术后逐渐缩小,A组左心形态逆转更为明显。B1组、B2组术前右心增大,术后均不同程度回缩。结论 PDA封堵术后肺动脉压不同程度降低,心脏形态重构明显。Objective To observe the ventricular morphological and pulmonary pressure changes after closure of PDA in trans-catheter by trans-thoracic echocardiography.Methods 28 patients with PDA divided into 3groups according to Systolic pulmonary arterial pressure（SPAP）and echocardiography.Group A：suffered with midrange PHT;Group B1：suffered with severe PHT and enlarged left ventricle;Group B2：suffered with severe PHT and normal left ventricle.Those diameters of LAD、LVEDD、LVESD、RAD、RVD、SPAP were measured and compared at different time：pre-operation、24hours,5days,1month,3months,6month,and 12 months after operation.Results（1）SPAP gravitated markedly in group A,which arrive normal level at 12 months after clossuing.SPAP in group B1 decreased faster than that in group B2.（2）Left ventricle and left auricle in group A and B1 gradually minificated after operation and retro conversion in group A was obviously.Right ventricle and auricle in group B1 and B2were some degree recovered after operation.Conclusions Preoperative hypertension gravitated some extent after trans-catheter occlusion,auricular and ventricular remodeling is markedly.

关 键 词：动脉导管未闭 介入封堵 肺动脉高压 超声心动图 心脏重构 

分 类 号：R540.45[医药卫生—心血管疾病] R654.2[医药卫生—内科学]