81例左冠状动脉异常起源于肺动脉临床诊治分析  

Clinical study of 81 cases of anomalous left coronary artery from the pulmonary artery

作　　者：姜小坤 肖燕燕[1] 李文秀[1] 王霄芳[1] 金梅[1] JIANG Xiaokun;XIAO Yanyan;LI Wenxiu;WANG Xiaofang;JIN Mei(Department of Pediatric Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所小儿心脏中心,100029

出　　处：《心肺血管病杂志》2020年第5期549-553,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:分析左冠状动脉异常起源于肺动脉(ALCAPA)患者的临床特点、诊断治疗方法、手术效果及远期随访,提高临床医师对此类疾病的诊断治疗水平。方法:回顾性分析1993年10月至2019年10月北京安贞医院小儿心脏中心诊治的81例左冠状动脉异常起源于肺动脉患者的临床及随访资料,对比婴儿型和成人型的临床特点和治疗预后。结果:本组81例患者按年龄分为婴儿型(发病年龄≤12月,40例)和成人型(发病年龄>12个月,41例)。65例患者行外科手术治疗,围术期死亡10例(15.4%)。手术出院后随访部分患者心电图异常Q波逐渐消失,左心室扩大及左心功能均明显改善,二尖瓣反流较术前减轻。结论:根据婴儿型和成人型ALCAPA临床表现,结合心电图、超声心动图、心脏CT及造影可明确诊断,外科手术重建双冠状动脉循环可有效改善心脏的结构和功能,术后远期预后良好。Objective:To analyze the clinical characteristics,diagnosis and treatment method,surgi-cal result and long-term follow-up of patients with anomalous left coronary artery from the pulmonary artery,to improve the level of diagnosis and treatment of such diseases.Methods:A retrospective study identified 81 patients diagnosed with anomalous left coronary artery from the pulmonary artery at Pediatric Heart Center of Beijing Anzhen Hospital from October 1993 to October 2019.The clinical characteristics and treatment prognosis of infant type and adult type were compared.Results:81 patients were divided into infant type(age≤12 months,40 cases)and adult type(age>12 months,41 cases).65 patients were treated by surgery,10 patients died in perioperative period(15.4%).In the follow-up,the abnormal Q wave of ECG gradually disappeared,left ventricular enlargement and left ventricular function were significantly improved,and mitral regurgitation was less than that before operation.Conclusions:according to the clinical manifestations of infant and adult ALCAPA,combined with ECG,echocardiography,cardiac CT and angiography,the diagnosis can be made clearly,and the surgical operation is very important Method.The long-term prognosis is good after operation.

关 键 词：先天性左冠状动脉异常起源 超声心动图 左冠状动脉移植术 

分 类 号：R54[医药卫生—心血管疾病]