法洛四联症患者左-主肺动脉夹角特点及其与肺动脉发育的关系  

Feature of the angulation between left pulmonary artery and main pulmonary artery and its relationship to pulmonary artery development in patients with tetralogy of Fallot

作　　者：曹嵘 陈鹏帆 王越 张煜宸 易文琪 何梦婷 凌云飞[1] 安琪[1] CAO Rong;CHEN Pengfan;WANG Yue;ZHANG Yuchen;Yl Wenqi;HE Mengting;LINGYunfei;AN Qi(Department of Cardiovascular Surgery,West China Hospital,Sichuan University,Chengdu,610041,P.R.China)

机构地区：[1]四川大学华西医院心脏大血管外科

出　　处：《中国胸心血管外科临床杂志》2020年第1期26-30,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：四川大学华西医院学科卓越发展1·3·5工程临床研究孵化项目(18HXFH021)

摘　　要：目的探讨法洛四联症(tetralogy of Fallot,TOF)患者左-主肺动脉夹角特点及其与肺动脉发育的关系。方法选择四川大学华西医院心脏大血管外科2014~2018年收治的TOF患者共101例作为研究组(TOF组),其中男62例、女39例,年龄6.8(0.3~45.8)岁;另选取同期无心脏基础疾病的患者20例作为对照组,其中男10例、女10例,年龄6.9(0.3~54.0)岁。测量并比较两组患者的左肺动脉(left pulmonary artery,LPA)直径、右肺动脉(right pulmonary artery,RPA)直径、主肺动脉(main pulmonary artery,MPA)直径、MPA-LPA夹角、McGoon比值、Nakata指数等指标。分析以上数据与MPA-LPA夹角大小的关系。结果TOF患者MPA-LPA夹角平均值较对照组小(113.63度vs.128.45度,P=0.0018)。TOF组MPA Z值小于对照组(0.46 vs.2.75,P=0.0004)。对照组和TOF组MPA-LPA夹角与LPA Z值、MPA Z值均无统计学关系(P值分别为:对照组,0.2396、0.1147;TOF组,0.7593、0.2427)。MPA-LPA夹角大小与手术方式的选择如是否跨瓣补片无关(P=0.1600)。结论TOF患者MPA-LPA夹角及MPA直径较非TOF患者小;MPA-LPA夹角大小与肺动脉直径、手术方式的选择无关。Objective To investigate the feature of the angulation between left pulmonary artery(LPA)and main pulmonary artery(MPA)and its relationship to pulmonary artery development in patients with tetralogy of Fallot(TOF).Methods A total of 101 TOF patients in West China Hospital from 2014 to 2018 were enrolled in a TOF group,including 62 males and 39 females,aged 6.8(0.3-45.8)years,and another 20 patients without basic cardiac diseases at the same stage were enrolled in a control group,including 10 males and 10 females,aged 6.9(0.3-54.0)years.Diameters of LPA,right pulmonary artery(RPA)and MPA,the angulation between LPA and MPA(MPA-LPA),McGoon ratio,and Nakata index were measured and compared between the two groups.The relationship between the above data and MPALPA angulation was also analyzed.Results The average MPA-LPA angulation was smaller in the TOF group than that in the control group(113.63°vs.128.45°,P=0.0018).The MPA Z score was also smaller in the TOF group than that in the control group(0.46 vs.2.75,P=0.0004).No relationship was found by correlation analysis between the MPA-LPA angulation and MPA Z score or LPA Z score in the control group(P=0.2396,0.1147)and the TOF group(P=0.7593,0.2427).The McGoon ratios(2.22±0.72,2.43±0.94,P=0.3400)and Nakata index(359.3±294.24,395.52±329.31,P=0.6500)were not significantly different between the two groups.Conclusion The angulation of LPA-MPA and MPA Z score are smaller in the TOF group than those in the control group.There is no relationship between MPA-LPA angulation and pulmonary artery diameters.The LPA-MPA angulation should not be considered as an influence factor for LPA development and trans-annular patch surgery.

关 键 词：法洛四联症 肺动脉 夹角 直径 

分 类 号：R541.1[医药卫生—心血管疾病] R725.4[医药卫生—内科学]