超声心动图对心脏移植术后右心形态学改变的观察及其机制分析  

Echocardiographic Observation of Right Heart Morphological Alter ation and Analysis of the Mechanism After Heart Transplantation

作　　者：刘健[1] 徐琳[1] 孙雅萍[1] 萧明第[2] 彭志海[3] 

机构地区：[1]上海市第一人民医院心超室,上海市200080 [2]上海市第一人民医院心外科,上海市200080 [3]上海市第一人民医院普外科,上海市200080

出　　处：《中国超声医学杂志》2003年第10期734-736,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 :观察心脏移植术后右心形态改变 ,并对其机制进行分析。方法 :研究对象共分为 3组 ;心脏移植组 (A组 )、肝脏移植组 (B组 )及正常对照组 (C组 ) ,A、B两组按术后激素用量大小分为第一及第二阶段 ,测量不同阶段右室舒张末期内径 (RVEDD)、右室舒张末期容积 (RVEDV)等指标观察右心形态及功能变化 ,同时观察三尖瓣返流情况并推测肺动脉压 ,将结果与正常组相比较 ,并进行统计学分析。持续观察 1年。结果 :A组患者第一阶段右心明显扩大 ,与正常组对照差别有显著性 ,右心扩大程度与手术后激素用量及补液量有关 ,B组患者术后第一阶段右心轻微增大 ,与正常组对照差别无显著性 ,第二阶段右心未见扩大。 A组患者手术后三尖瓣返流持续存在 ,与肺动脉压无关。结论 :心脏移植术后右心明显扩大 ,与右心容量负荷增加导致的钠水潴留有关 。Objective:To observe the morphologica l alteration of right heart and analyse the mechanism after heart tansplantation Methods:All objects were divided into 3 groups:group A:he art transplantation group; group B:hepartransplantation group; group C:normal co ntrol group Two of these three groups( A and B) were divided into 2 stages ac cording to the variant dosages of steriod hormone adminastrations The parameter s as right ventricular end diastolic diameter(RVEDD),its volume(RVEDV) and pulmo nary pressure etc were determined and compared with those of the control group i n two stages within one year Results:The degree of right heart dilatation was much higher in group A than that in group B and the differ ence was significient The dilatation extents related to the dosages of steriod hormone and fluid infusion obviously The right heart size in group B was incre ased slightly in the first stage,but no enlargement was found during the second stage There was persistent tricuspid regurgitation in group A after heart trans plantation without relationship to pulmonary pressure Conclusions:The right heart which was obviously enlarged after heart transplantation probably related to load incresement due to sodium a nd fluid retention which was caused by abnormal cardiorenal neuroendocrine refle xes secondary to cardiac denervation

关 键 词：超声心动图 心脏移植术 右心室 形态学 钠水潴留 心肌缺血 

分 类 号：R445.1[医药卫生—影像医学与核医学]