实时三维超声心动图评价不同肺动脉高压房间隔缺损患者右室形态及功能

目的 探讨实时三维超声心动图在评价不同程度肺动脉高压的房间隔缺损患者右心室形态及功能改变中的准确性及可行性.方法 选取60例单纯继发孔型房间隔缺损患者作为病例组,根据三尖瓣反流峰速估测的肺动脉收缩压将病例组分为轻、中、重度3组,选取34例健康体检者作为正常对照组,利用实时三维超声心动图分别测量4组研究对象的右室舒张末容积、右室收缩末容积、每搏量及射血分数,并将所测各组右心室参数进行统计分析.结果 重度组较之轻、中度组及正常对照组,右室舒张末容积、右室收缩末容积明显增大,右室射血分数明显减小（P＜0.05）;中度组较之轻度组及正常对照组,右室舒张末容积、右室射血分数增大（P＜0.05）;轻度组右室舒张末容积、右室收缩末容积、右室每搏量及右室射血分数较之正常对照组均无明显差异.结论 实时三维超声心动图技术可无创、准确地评价不同程度的肺动脉高压对房间隔缺损患者右室形态及功能的影响,为临床诊疗提供可靠依据.

Assessment of right ventricular morphology and function in atrial septal defect with different pulmonary artery hypertension by real-time three-dimensional echocardiography

Objective To study the accuracy and feasibility of real-time three-dimensional echocardiography in the assessment of right ventricular morphology and function in atrial septal defect patients with different pulmonary artery hypertension.Methods Sixty atrial septal defect patients with pulmonary artery high were divided into three groups （mild group,moderate group and severe group） according to pulmonary artery systolic pressure,which was calculated through the three tricuspid regurgitation.Thirty-four healthy volunteers were enrolled as normal control group.Real-time three dimensional echocardiography was performed in four groups to evaluate parameters concerning modality and function of participants＇ right ventricle,including right ventricular end diastolic volume （EDV）,end systolic volume （ESV）,stroke volume （SV） and right ventricle ejection fraction （EF）.Results Compared with mild group,moderate group and normal control group,EDV,ESV of severe group＇s increased obviously,and EF significantly decreased （P ＜0.05）; compared with mild group and normal control group,EDV and EF increased in moderate group （P ＜0.05）; there was no evident difference between mild group and normal control group.Conclusion Real-time three dimensional echocardiography can be a noninvasive and accurate technique in the assessment of right ventricular morphology and function in atrial septal defect patients with different pulmonary artery hypertension,and can provide reliable basis for clinical diagnosis and treatment.