无顶冠状静脉窦综合征的超声影像学及临床特征分析  

Analysis on Echocardiographic Imaging and Clinical Feature of Patients With Unroofed Coronary Sinus Syndrome

作　　者：弓文清 魏汝峰 胥盼 马慧 董洪娜 郑敏娟 GONG Wenqing;WEI Rufeng;XU Pan;MA Hui;DONG Hongna;ZHENG Mnijuan(Department of Ultrasound,Xijing Hospital,Air Force Medical University,Xi'an(710032),Shanxi,China)

机构地区：[1]空军军医大学西京医院超声医学科,陕西省西安市710032 [2]汉中市中心医院超声科 [3]西安市高新医院超声科

出　　处：《中国循环杂志》2021年第2期161-165,共5页Chinese Circulation Journal

基　　金：陕西省国际合作项目(2015KW-049);空军军医大学第一附属医院助推计划(XJGX15Y16)。

摘　　要：目的:分析无顶冠状静脉窦综合征(unroofed coronary sinus syndrome,UCSS)患者超声影像学及临床特征。方法:回顾我院2007年1月至2020年1月临床确诊的140例UCSS患者超声影像资料,对其超声影像特征、合并畸形及继发改变进行分析。结果:140例UCSS患中,女性占62.1%(87/140),且以Ⅰ型为主(45.0%,63/140),缺损范围达(17.16±9.64)mm。111例(79.3%,111/140)UCSS患者合并心血管畸形,最常见的心脏畸形为房间隔缺损(67.5%,75/111)、永存左上腔(40.5%,45/111)及心内膜垫缺损(24.3%,27/111);房间隔好发类型以继发孔型缺损及卵圆孔未闭(PFO)居多,分别占57.3%(43/75),PFO占25.3%(19/75)。继发心脏改变主要是右心房增大和肺动脉高压(48.6%,68/140),Ⅲ型患者肺动脉高压及三尖瓣中度以上反流的发生率显著高于其他两型(P<0.05)。59.0%(49/83)患者有心电图异常。结论:无顶冠状静脉窦女性好发,Ⅰ型常见,常合并多种心血管畸形,继发右心房增大,肺动脉压增高。Objectives:To analyze the echocardiographic image features and clinical data of patients with Unroofed Coronary Sinus Syndrome(UCSS).Methods:We retrospectively analyzed the echocardiographic imaging data of 140 UCSS patients,who were diagnosed by cardiovascular surgery from Jan.2007 to Jan.2020 in our hospital.Imaging characteristics,typical secondary manifestations and combined malformation were summarized.Results:Prevalence of UCSS was high in women(62.1%)in this cohort,and Type Ⅰ UCSS was common(45.0%)and the mean defect range was(17.16±9.64)mm.111(79.3%)patients had concomitant cardiovascular malformations.The main complications were atrial septal defect(67.5%,75/111),permanent left superior vena cava(40.5%,45/111),and endocardial cushion defect(24.3%,27/111).The most common types of atrial septum defect were secundum atrial septal defect and patent foramen ovale(PFO),which accounted for 57.3%(43/75),and PFO accounted for 25.3%(19/75).The secondary manifestations were enlarged right atrium,pulmonary hypertension(48.6%,68/140),the incidence of pulmonary hypertension and medium or massive tricuspid regurgitation were significantly higher especially in type Ⅲ patients than in type Ⅰ and Ⅱ patients(P<0.05).59.0%(49/83)patients had abnormal ECG.Conclusions:Prevalence of UCSS is high in women in this cohort,Type Ⅰ UCSS is common,and is often complicated with a variety of cardiovascular malformations.Secondary manifestations are right atrium enlargement,and pulmonary hypertension.

关 键 词：无顶冠状静脉窦综合征 冠状静脉窦 超声心动图 先天性心脏病 

分 类 号：R541.4[医药卫生—心血管疾病]