应用左、右心室舒张末期内径比值判断房间隔缺损封堵术后随访终点

目的探讨应用左、右心室舒张末期内径比值（LVDD/RVDD）判断房间隔缺损（ASD）封堵术后随访终点的可行性。方法将47例ASD患者根据ASD直径分为小缺损亚组（〈10mm）、中缺损亚组（10～20mm）和大缺损亚组（〉20mm）。选择同期接受健康体检者422名作为对照组,观察ASD患者经导管封堵术前及术后1周、1、3、6个月TTE测量LVDD/RVDD的变化。结果①对照组LVDD/RVDD的均值为2.53±0.27,性别差异无统计学意义;②术前3个亚组ASD患者LVDD/RVDD均低于对照组（P均〈0.05）,缺损越大,LVDD/RVDD越低,中缺损亚组与大缺损亚组LVDD/RVDD差异无统计学意义;③术后6个月3个亚组ASD患者LVDD/RVDD均值均在正常值范围内,但小缺损亚组达正常下限和上限者最多;④小缺损亚组术前LVDD/RVDD明显大于其他亚组（P均〈0.05）,但同样能从ASD封堵术中获益,且术后1周LVDD/RVDD即恢复正常水平。结论 LVDD/RVDD值可作为判断ASD患者经导管封堵术后随访终点的个体化指标。

Using left ventricular end diastolic diameter/right ventricular end diastolic diameter as index for ending follow-up after transcatheter closure of atrial septal defect

Objective To explore the application value of the ratio of left ventricular end diastolic diameter to right ventricular end diastolic diameter(LVDD/RVDD) as index for ending follow-up after transcatheter closure of atrial septal defect(ASD).Methods Totally 47 patients with ASD who underwent transcatheter closure of ASD were divided into small(<10 mm),medium(10—20 mm) and big defect subgroups(>20 mm).Meanwhile 422 norml objects were enrolled as the control group.LVDD/RVDD was measured with TTE in all subjects,for ASD patients the measurement was performed before and 1 week,1,3 and 6 months after closure.Results ①In control group,LVDD/RVDD was 2.53±0.27,there was no difference between male and female subgroups.②Before closure,LVDD/RVDD of ASD patients was lower than that of control group(P<0.05).The bigger the defect,the lower the LVDD/RVDD.There was no difference between medium defect group and big defect group.③Six months after closure,the mean value pf LVDD/RVDD returned to normal range in all ASD subgroups,while there were more patients with LVDD/RVDD beyond normal lower and upper limit in small defect subgroup than the other subgroups of ASD.④Before closure,LVDD/RVDD of small defect subgroup was distinctly bigger than the other two subgroups(both P<0.05).Patients in small defect subgroup of ASD could benefit from transcatheter closure,and LVDD/RVDD returned to normal range 1 week after closure.Conclusion LVDD/RVDD can be used as a briefness index for ending follow-up for patients after transcatheter closure of ASD.