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超声心动图和左室造影测量膜部室间隔缺损的相关研究 (PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2005年第2期
页码:
192-194
栏目:
介入治疗
出版日期:
2005-03-05

文章信息/Info

Title:
comparative study on the measurement of ventricular septal defect by ultrasoundcardiogram and by left ventriculography
作者:
李敬邦1;  张玉顺1;  李寰1;  代正学1;  李军2;  张军2
第四军医大学西京医院:1.心脏内科, 2.超声诊断科，陕西 西安 710032
Author(s):
LI Jingbang1;  ZHANG Yushun1;  LI Huan1;  DAI Zhengxue1;  LI Jun2;  ZHANG Jun2
1.Department of Cardiology, 2. Department of ultrasounddiagnosis, Xijing Hospital, Fourth Military Medical University, Xi’an,Shaanxi 710032， China
关键词:
室间隔缺损;  超声心动描记术;  心室造影
Keywords:
ventricular septal defect;  ultrasoundcardiogram;  ventriculography
分类号:
R540.45
DOI:
-
文献标识码:
A
摘要:
目的 对比分析超声心动图(UCG)和左室造影(LV)定量测量膜(周)部室间隔缺损（VSD）的相关性。方法 全组患者106(男49，女57)例,年龄2~45(9.6±8.3)岁。UCG采用非标准左室长轴、大血管短轴及五腔切面；LV取左前斜位45°~60°加头位25°，测量VSD的大小，与主动脉瓣右冠瓣的距离。结果 LV测量VSD大小显著大于左室长轴超声测量值（7.4±2.9 mm vs 5.2±2.3 mm, P<0.05）,而与大血管短轴及五腔心切面UCG测量值（7.0±2.9 mm，7.0±3.2 mm）无显著性差异（P>0.05）。大血管短轴与五腔心切面UCG测量VSD大小值之间无显著性差异（P>0.05），但显著大于左室长轴切面测值（P<0.05）。LV测量VSD距主动脉瓣距离显著大于左室长轴切面测值（3.4±1.0 mm vs 2.3±0.7 mm, P<0.05），而与五腔心切面测值(3.0±1.0 mm)无显著性差异（P>0.05）。五腔心切面所测室间隔缺损距主动脉瓣距离亦与LV测值显著相关(r=0.84, P<0.01)。UCG在大血管短轴切面所测室缺与三尖瓣的距离为3.3±1.3(1.5~7）mm。结论 膜部VSD介入治疗时仍应以LV测量VSD的大小和位置为选择封堵器的“金标准”，UCG测量可以作为左室造影的重要补充；而VSD与三尖瓣的距离只能用UCG测量。
Abstract:
AIM To compare the measurement of ventricular septal defect (VSD) by ultrasoundcardiogram (UCG) and by left ventriculography (LV). METHODS Total 106 VSD patients (49 male, 57 female), aged from 2 to 45 (average, 9.6±8.3), were investigated. By UCG, the size of VSD and the distance between VSD and the right coronary cusp was measured at nonstandard parasternal left heart long axis view, parasternal aortic short axis view and apical 5chamber view. By LV, the size of VSD and the distance between VSD and right coronary cusp were measured in left anterior oblique 45° ~60° +cranial 25°LV. RESULTS The size of VSD measured in LV was significantly larger than that measured by parasternal left heart long axis view UCG (7.4±2.9 mm vs 5.2±2.3 mm, P<0.05), but no significant difference with that measured by parasternal aortic short axis view and apical 5chamber view UCG (7.0±2.9 mm vs 7.0±3.2 mm, P>0.05). The size of VSD measured by parasternal aortic short axis view UCG had no significant difference with that measured at apical 5chamber view UCG (P>0.05),but was significantly larger than that measured at parasternal left heart long axis view UCG (P<0.05).The distance of VSD to aortic valve measured by LV was significantly larger than that measured by parasternal left heart long axis view UCG (3.4±1.0 mm vs 2.3±0.7 mm, P<0.05)，but no significant difference with that measured by apical 5chamber view UCG (3.4±1.0 mm vs 3.0±1.0 mm, P>0.05). The distance between VSD and aortic valve measured by apical 5charmer view UCG was also significantly correlated with that measured by LV (r=0.84, P<0.01). The distance betweem VSD and tricuspid valve measured by parasternal aortic short axis view UCG was from 1.5 to 7 mm (averaged, 3.3±1.3mm). CONCLUSION The size and location of VSD measured by LV should be "golden standard" in selecting the occluders in transcatheter occlusion of VSD. UCG can be an important complementary to LV. The distance of VSD to tricuspid valve can only be measured by UCG.

参考文献/References

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［3］ Sideris EB, Walsh KP, Haddad JL, et al. Occlusion of congenital ventricular septal defects by the “buttoned device”. Clinical trials international register［J］. Heart, 1997, 77(3):276-279.

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［6］ Hijazi ZM, Hakim F, AlFadley F, et al. Transcatheter closure of single muscular ventricular septal defects using the amplatzer muscular VSD occluder: initial results and technical considerations［J］. Catheter Cardiovasc Interv, 2000, 49(2):167-172.

［7］秦永文, 赵仙先, 徐荣良,等. 经导管闭合膜部室间隔缺损的临床应用研究［J］.中国循环杂志, 2002, 17(Supp):52-54.

备注/Memo

备注/Memo:
收稿日期：2004-12-30.
更新日期/Last Update: 2010-01-05