267例先天性脊柱侧凸患者心血管系统异常的临床特点分析  

Clinical Characteristics of Cardiovascular Abnormalities in 267 Patients with Congenital Scoliosis

作　　者：刘春霞 谭焜月 熊峰 王淑珍 黄晓凤 张丽娟 徐敏 赵若寒 LIU Chunxia;TAN Kunyue;XIONG Feng;WANG Shuzhen;HUANG Xiaofeng;ZHANG Lijuan;XU Min;ZHAO Ruohan(Department of Cardiology,The Affiliated Hospital of Southwest Jiaotong University,The Third People’s Hospital of Chengdu,Cardiovascular Disease Research Institute of Chengdu,Chengdu 610031,Sichuan,China)

机构地区：[1]西南交通大学附属医院,成都市第三人民医院心内科,成都市心血管病研究所,四川成都610031

出　　处：《心血管病学进展》2022年第11期1038-1042,共5页Advances in Cardiovascular Diseases

摘　　要：目的对先天性脊柱侧凸(CS)患者合并心血管系统异常的临床特点进行回顾性分析。方法纳入2015年1月—2020年12月在成都市第三人民医院骨科住院治疗的CS患者共267例,结合脊柱X射线、CT、磁共振成像、主动脉CT血管成像和经胸超声心动图等临床资料,分析CS患者椎体异常、椎管内异常、先天性心血管异常、心血管结构参数异常、心功能参数异常、瓣膜反流和肺动脉高压等情况。结果本研究中的CS患者平均年龄(23.87±6.36)岁,主弯Cobb角(83.30±27.46)°;椎体异常中以形成障碍型发生率最高(40.45%),其次为混合型(32.58%);合并椎管内异常发生率40.07%,其中脊髓纵裂发生率最高(29.21%);CS合并心血管异常总发生率较高(54.68%),先天性心血管异常发生率12.73%,非先天性心血管异常发生率48.07%;除先天性心血管异常外,CS患者心血管结构异常方面以左心房增大最多见(12.45%),其次为肺动脉增宽(10.30%);心功能异常方面以左心室舒张功能参数二尖瓣环舒张早期运动峰值速度(Ee)/舒张晚期运动峰值速度(Ea)<1最常见(19.31%),其次为二尖瓣口舒张早期峰值速度(E)/Ee>14(12.45%);瓣膜异常方面以房室瓣反流多见,三尖瓣反流发生率最高(16.31%),其次为二尖瓣反流(8.15%);另外,CS患者肺动脉收缩压升高发生率较高(14.16%)。结论CS患者心血管异常总发生率较高,CS患者可能较早出现心血管结构和/或功能异常,术前应全面评价CS患者心血管结构及心功能状态。Objective To retrospectively analyze the clinical characteristics of congenital scoliosis(CS)with cardiovascular abnormalities.Methods A total of 267 CS patients who were hospitalized in the Department of Orthopedics of The Third People’s Hospital of Chengdu from January 2015 to December 2020 were included,and were analyzed for vertebral and intraspinal abnormalities,congenital cardiovascular abnormalities,cardiovascular structural parameters and cardiac function parameters,valvular regurgitation and pulmonary artery pressure.Results Average age of CS patients was(23.87±6.36)years,and average Cobb angle of main bend was(83.30±27.46)°.The highest incidence of vertebral anomalies was failure of formation type(40.45%),followed by mixed defects(32.58%).The incidence of intraspinal abnormalities was 40.07%,among which diastematomyelia(29.21%)was more than other types.The overall incidence of cardiovascular abnormalities in CS was high(54.68%),with a 12.73%incidence of congenital cardiovascular anomalies and a 48.07%incidence of non-congenital cardiovascular anomalies.In addition to congenital cardiovascular anomalies,left atrial enlargement(12.45%)was the most common cardiovascular structural abnormalities in CS patients,followed by pulmonary artery widening(10.30%).In terms of cardiac function abnormalities,early diastolic mitral annular velocity(Ee)/late diastolic mitral annular velocity(Ea)<1 was the most common(19.31%),followed by early transmitral flow velocity(E)/Ee>14(12.45%).In terms of valve abnormalities,atrioventricular regurgitation was the most,with the highest incidence of tricuspid regurgitation(16.31%),followed by mitral regurgitation(8.15%).In addition,the incidence of elevated pulmonary artery systolic pressure was 14.16%in CS patients.Conclusion The overall incidence of cardiovascular abnormalities is high in CS patients,who may develop cardiovascular structure and/or functional abnormalities earlier than normals.Preoperative comprehensive evaluation of cardiovascular structure and cardiac func

关 键 词：先天性脊柱侧凸 椎管内异常 心血管异常 结构 心功能 

分 类 号：R681.5[医药卫生—骨科学]