超声心动图在三尖瓣下移畸形矫治术中的应用价值  

Application Value of Echocardiography in Correction of Ebstein’s Anomaly

作　　者：王奖 严和意 赵婉玉 董云兴 钟德琳 沈艳[1] 骆志玲[1] Wang Jiang;Yan Heyi;Zhao Wanyu;Dong Yunxing;Zhong Delin;Shen Yan;Luo Zhiling(Depatment of Ultrasound,Cardiovascular Hospital Affiliated to Kunming Medical University,Fuwai Yunnan Cardiovascular Hospital,Kunming 650101,China)

机构地区：[1]昆明医科大学附属心血管病医院(云南省阜外心血管病医院)超声科,昆明市650101

出　　处：《中国超声医学杂志》2022年第12期1365-1368,共4页Chinese Journal of Ultrasound in Medicine

基　　金：云南省心血管病临床医学中心项目(No.FZX2019-06-01);昆明医科大学-学科建设(No.601202232);国家自然科学基金(No.31960133);云南省教育厅科学研究基金(No.2019J1301)。

摘　　要：目的 分析EA矫治术患者手术前后超声心动图特征,总结超声心动图在EA患者中的应用价值。方法 回顾性分析39例EA矫治术患者。收集其手术前后一年临床特征、实验室和超声心动图资料,并分析上述资料的手术前后的变化。结果 39例EA患者,男9例,年龄(22.5±16.3)岁。Carpentier A型8例、B型10例、C型12例、D型9例,均进行EA矫治术,其中2例加做Glenn术。心功能分级较术前改善(P<0.05),NT-proBNP、Crea、AST、HGB、SO2、RA面积、解剖RV的大小、三尖瓣瓣环直径、LVEI、TAPSE较术前减小(P<0.05),fRV面积、RVFWSL、RVGSL较术前增加(P<0.05)。术后心功能分级变好的患者术前房水平分流全部为左向右分流,Carpentier分型主要为A型和B型,仅1例存在瓣叶粘连、牵拉,GOSE值小于心功能分级变差患者(P<0.05)。结论 超声心动图对三尖瓣瓣叶发育情况的评价可为治疗决策提供重要依据,右室应变中的RVPALS、RVGSL指标可较好评估右心功能。Objective To analyze the characteristics of echocardiography before and after correction of EA in our hospital and summarize the application value of echocardiography in EA patients. Methods 39 patients accept correction of EA in our hospital were retrospectively analyzed. Clinical characteristics, laboratory and echocardiographic data were collected before and after surgery, and their changes before and after surgery were analyzed. Results Among 39 EA patients, 9 were males, aged(22.5±16.3) years. There were Carpentier classification: 8 cases of A, 10 cases of B, 12 cases of C, and 9 cases of D,all of which were accepted EA correction, including 2 patients with Glenn. Improved grading of cardiac function compared with before the surgery(P<0.05), NT-proBNP, Crea, AST, HGB, SO2,RA area anatomical RV size、tricuspid annulus diameter、LVEI, TAPSE decreased compared with before the surgery(P<0.05), fRV area, RVFWSL, RVGSL increased compared with before the surgery(P<0.05).Patients with improved cardiac function grading were left to right in preoperative atrial shunt, Carpentier classification was mainly A and B, Only 1 patient had valvular adhesion and traction, and THE GOSE value was less than that of patients with deteriorated cardiac function grading(P<0.05). Conclusions Echocardiography evaluation of Tricuspid valve development can provide an important basis for treatment decision-making, and RVFWSL, RVGSL indexes of right ventricular strain can better evaluate right heart function.

关 键 词：三尖瓣下移畸形 超声心动图 右心功能 

分 类 号：R540.45[医药卫生—心血管疾病] R654.2[医药卫生—内科学]