右室流出道狭窄患者合并肺动脉高压的超声心动图特征及形成原因分析  

Echocardiographic features and causes of right ventricular outflow tract stenosis complicated with pulmonary arterial hypertension

作　　者：刘娜迪 黄云洲[2] 李冬蓓[2] 王翠华[2] 周建华[2] 陈新华[2] LIU Na-di;HUANG Yun-zhou;LI Dong-bei(Chengde Medical College,Hebei 067000,China)

机构地区：[1]承德医学院,河北067000 [2]泰达国际心血管病医院超声科,天津300457

出　　处：《中国临床新医学》2020年第5期504-508,共5页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的应用超声心动图技术探讨右室流出道狭窄(right ventricular outflow tract stenosis,RVOTS)患者合并肺动脉高压(pulmonary arterial hypertension,PAH)的形成原因。方法回顾性分析经外科手术证实的8例RVOTS合并PAH患者的术前超声图像及临床资料。结果形成PAH的原因包括:3例存在大动脉水平分流,2例合并主动脉瓣反流和房颤等左心疾患,1例PAH为一过性,另2例分别为室间隔缺损(ventricular septal defect,VSD)与RVOTS不匹配合并大动脉水平分流,VSD在RVOTS之后、大动脉水平分流合并主动脉瓣下狭窄和主动脉瓣反流等。结论少数先天性心脏病RVOTS患者因多种原因可合并PAH,超声心动图检查可进一步明确其原因,为临床干预提供可靠依据。Objective To investigate the causes of right ventricular outflow tract stenosis(RVOTS)complicated with pulmonary arterial hypertension(PAH)using echocardiographic technique.Methods The preoperative echocardiographic images and clinical data of 8 patients with RVOTS and PAH proved by surgery in our hospital were retrospectively analyzed.Results The possible causes of PAH included that arterial-level shunt in 3 cases,left heart diseases including aortic regurgitation and atrial fibrillation in 2 cases,and transient PAH in 1 case.There were multiple influencing factors in the other 2 cases,such as mismatch between ventricular septal defect(VSD)and RVOTS with arterial-level shunt,and VSD occurring after RVOTS,followed by left heart diseases of arterial-level shunt complicated with subaortic stenosis and aortic regurgitation.Conclusion A few congenital heart disease patients have RVOTS complicated with PAH for many reasons.It is necessary to further analyze the causes of the disease to provide a reliable basis for the selection of clinical interventions.

关 键 词：超声心动图 右室流出道狭窄 肺动脉高压 

分 类 号：R540.45[医药卫生—心血管疾病]