儿童左冠状动脉异常起源于肺动脉的超声心动图及临床特征分析  

The characteristics of echocardiography and clinical for anomalous origin of the left coronary artery from the pulmonary artery in children

作　　者：张红菊 刘国文 孙妍[1] 杨娇 李静雅[1] 马桂琴[1] 张鑫[1] 薛丽 王俊 马宁[1] ZHANG Hongju;LIU Guowen;SUN Yan;YANG Jiao;LI Jingya;MA Guiqin;ZHANG Xin;XUE Li;WANG Jun;MA Ning(Department of Echocardiography,Beijing Children’s Hospital,Capital Medical University,National Center for Children’s Health,Beijng 100045,China)

机构地区：[1]国家儿童医学中心首都医科大学附属北京儿童医院心脏超声科,100045

出　　处：《心肺血管病杂志》2021年第1期78-82,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨左冠状动脉异常起源于肺动脉(ALCAPA)的超声心动图及临床特征。方法:回顾性分析首都医科大学附属北京儿童医院2007年1月至2019年12月间,经手术治疗的ALCAPA患儿的临床资料。对不同年龄组间的参数比较,采用Kaplan-Meier法和Log-rank检验进行生存分析。结果:46例ALCAPA患儿中,其中婴儿型占60.9%。与成人型ALCAPA患儿比较,婴儿型ALCAPA患儿呼吸急促和口周发绀等心力衰竭症状的发生率明显高于成人型(P<0.001);且婴儿型ALCAPA患儿左心室扩张程度较成人型ALCAPA患儿更明显、左心室收缩功能明显减低,两组间差异有统计学意义(P<0.001)。预后分析显示:婴儿型ALCAPA患儿短期生存率明显低于成人型ALCAPA患儿(P=0.048),但两组间长期生存率差异无统计学意义(P>0.05)。结论:婴儿型ALCAPA患儿临床及超声心动图表现较成人型ALCAPA患儿重,短期死亡率高,但远期预后良好。Objective:To investigate echocardiographic and clinical characteristics of anomalous origin of the left coronary artery from the pulmonary artery(ALCAPA).Methods:Clinical data of 46 patients with ALCAPA after surgical at Beijing Children’s Hospital between January 2007 and December 2019 were retrospectively identified.Statistical comparisons were performed using Independent sample T tests and Fisher exact tests.Cumulative survival curves were estimated by Kaplan-Meier method and compared between groups using the log-rank test.Results:Of the 46 patients that were analyzed,28(60.9%)presented in infantile type.The patients in infantile type had more frequent symptoms of congestive heart failure as well as tachypnea when compared to patients in adult type(P<0.001);Furthermore,LVEDD was significantly higher,but the LVEF was significantly lower in patients with infantile type than patients with adult type(P<0.001).Following surgery,the short-term survival rate was lower in infantile type than in adult type(P=0.048),but there were no significant differences between two groups on long-term survival rate(P>0.05).Conclusions:Among patients with ALCAPA,those patients presented in infantile type have a distinctly worse natural history and outcomes among short-term,but long-term outcomes are excellent.

关 键 词：冠状动脉起源异常 超声心动图 临床特点 预后 

分 类 号：R54[医药卫生—心血管疾病]