实时三维超声心动图评价房间隔缺损患者右心室功能及其影响因素_临床医学论文.docVIP

实时三维超声心动图评价房间隔缺损患者右心室功能及其影响因素_临床医学论文 实时三维超声心动图评价房间隔缺损患者右心室功能及其影响因素_临床医学论文 【摘要】 　　目的应用实时三维超声心动图（RT3DE）技术评价房间隔缺损（ASD）患者右心室功能及其影响因素。方法应用实时三维长轴八平面法（LA 8）测量并比较20例ASD患者及20例正常对照者右室舒张末期容积、收缩末期容积及右室射血分数，并将ASD患者射血分数与缺损最大径、年龄、肺循环与体循环血流量之比（Qp/Qs）进行相关分析。结果ASD患者右室舒张末期容积、收缩末期容积均大于对照组，右心室射血分数明显低于对照组。射血分数与缺损最大径、Qp/Qs高度相关(r= -0.72，-0.67，0.05)，与年龄无相关性。结论RT3DE能准确评价右室容积与功能，ASD患者右室容量负荷功能减退，右心功能下降与分流量及缺损最大径有关。 【关键词】 实时三维显像 右心室功能 房间隔缺损 　　Abstract:ObjectiveTo assess the right ventricular function and its determinants in patients with atrial septal defect using real-time three-dimensional echocardiography. MethodsThe right ventricular end-systolic volume, right ventricular end-diastolic volume, right ventricular ejection function in 20 atrial septal defect patients and 20 health individuals were measured by RT3VE and the correlation between the right ventricular ejection fraction and the largest size of defect, age and the ratio of pulmonary to systemic flow (Qp/Qs) in ASD patients was evaluated. ResultsThe right ventricular end-diastolic volume (RVEDV) and right ventricular end-systolic volume (RVESV) of ASD group were higher than those of the control group, but the right ventricular ejection fraction (RVEF) was obviously lower than that of the control group. In the present study, the RVEF of ASD group was correlated with the largest defect size and Qp/Qs (r= -0.72，-0.67，0.05)，and had no related with the age of patient. ConclusionRT3DE can evaluate right ventricular volume and function accurately. The right ventricular function in patients with ASD was impaired and correlated with ASD shunt ratio and the largest size of defect. 　　Key words:Real-time three-dimensional imaging； Right ventricular function； Atrial septal defect 　　右心室容积和射血分数是评价右室功能的重要指标，房间隔缺损（ASD）患者右心室容积和功能的准确评价对其病情程度估价、治疗方案选择及疗效预后判断有重要临床价值［1］。本研究旨在应用实时三维超声心动图(RT3DE) 长轴八平面法（LA 8-plane）评价ASD组和正常对照组右室容积及功能变化，并探讨影响ASD患者右心室收缩功能的主要因素。 　　1 资料与方法 　　1.1 研究对象20例继发孔型ASD患者，男8例，女12例，年龄7～54岁，平均(28.4±10.8)岁。所有患者均为窦性心律，心功能Ⅰ～Ⅱ级。20例年龄、性别匹配的正常