| 刘晗,刘安宁,李玉宏.XPLANE技术评价经皮介入封堵房间隔缺损前后右心室功能[J].中国医学影像技术,2020,36(6): |
| XPLANE技术评价经皮介入封堵房间隔缺损前后右心室功能 |
| XPLANE technique for evaluation on right ventricular function of atrial septal defect patients before and after percutaneous intervention |
| 投稿时间：2019-06-11 修订日期：2020-06-14 |
| DOI： |
| 中文关键词: 心脏缺损，先天性 心室功能，右 介入治疗 超声检查 |
| 英文关键词:heart defects, congenital ventricular function, right interventional therapy ultrasonography |
| 基金项目:辽宁省自然科学基金（20170540381）、辽宁省兴辽英才计划项目（XLYC1802049） |
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| 中文摘要: |
| 目的 探讨采用XPLANE技术测量右心室纵向缩短分数（LSF）以评估房间隔缺损（ASD）患者经皮介入封堵术（PI）前后右心室功能变化的应用价值，并分析及其影响因素。方法 收集68例经超声检查诊断ASD并接受PI的患者，分别于术前、术后1个月、术后3个月对所有患者进行超声心动图检查，采用XPLANE技术测量并比较手术前后其二腔心切面（LSFAP2）和四腔心切面（LSFAP4）图像的LSF及二者均值（LSFAPM）、三尖瓣环收缩期位移（TAPSE）、肺动脉高压(PH)分级、右心室与左心室舒张末期内径比（RVEDD/LVEDD）分级的差异，分析LSFAP2、LSFAP4、LSFAPM与TAPSE的相关性及LSFAPM的影响因素。结果 术后1个月及术后3个月患者RVEDD/LVEDD（H=76.07、77.74）、PH分级（H=42.02、49.83）均较术前降低（P均＜0.05）。PI前后3个时间点患者右心室LSFAP2、LSFAP4、LSFAPM及TAPSE差异均有统计学意义（F=6.11、3.18、8.35、20.28，P均＜0.05）；术前LSFAP4、LSFAPM与术后3个月差异无统计学意义（t=1.45、0.22，P均＞0.05），余3个时间点LSFAP2、LSFAP4、LSFAPM、TAPSE两两比较差异均有统计学意义（P均＜0.05）。PI前后各LSF参数与TAPSE均呈正相关（P均＜0.05）。年龄、术前PH分级为3个时间点LSFAPM的共同影响因素。结论 XPLANE技术可有效测量ASD患者PI前后右心室功能变化；患者术后右心室形态及功能均改善，且术前及术后LSF参数与TAPSE的变化趋势基本一致，年龄和术前PH分级为术前及术后右心功能的影响因素。 |
| 英文摘要: |
| Objective To explore the application value of XPLANE technique in measuring right ventricular longitudinal shortening fraction (LSF) to evaluate the changes of right ventricular function in patients with atrial septal defect (ASD) before and after percutaneous intervention (PI), and to analyze its influencing factors. Methods Totally 68 ASD patients diagnosed with ultrasound and accepted PI were collected, and all patients underwent echocardiography before PI, 1 month and 3 months after PI, respectively. Then LSF of apical plane of 2-chamber (LSFAP2) and apical plane of 4-chamber (LSFAP4) images and mean of LSFAP2 and LSFAP4 (LSFAPM), tricuspid annular plane systolic excursion (TAPSE), pulmonary hypertension (PH) grading, right ventricle end-diastolic diameter/left ventricle end-diastolic diameter (RVEDD/LVEDD) grading before and after PI were measured and compared with XPLANE technique. The correlation of LSFAP2, LSFAP4, LSFAPM and TAPSE, and the influencing factors of LSFAPM were analyzed. Results RVEDD/LVEDD (H=76.07, 77.74) and PH (H=42.02, 49.83) grading of 1 month and 3 months after PI were lower than those before operation (all P＜0.05). There were statistical differences of LSFAP4, LSFAP2, LSFAPM and TAPSE in right ventricle of patients before and after PI ((F=6.11, 3.18, 8.35, 20.28, all P＜0.05). NO statistical difference between LSFAP4 and LSFAPM before PI and those after PI were found (t=1.45, 0.22, both P＞0.05). There were statistical difference of remaining LSFAP2, LSFAP4, LSFAPM and TAPSE before and after PI (all P＜0.05). LSF parameters before and after PI were positively correlated with TAPSE (all P＜0.05), age and preoperative PH grading were the common influencing factors of LSFAPM before and after PI. Conclusion XPLANE technique can effectively measure the changes of right ventricular function in patients with ASD before and after PI; the morphology and function of right ventricle in patients are improved after PI, and the variation trend of LSF parameters and TAPSE in patients before and after PI are basically the same, age and preoperative PH grading are important factors influencing right heart function before and after PI. |
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