经皮球囊肺动脉瓣成形术后右室舒张功能的研究

AStudyonrightventriculardiastolicfunctioninpatientswithpulmonicvalvestenosisafterpercuta┐neousbaloonpulmonaryvalvuloplasty

应用超声心动图测试３６例单纯肺动脉瓣狭窄（ＰＳ），经球囊扩张法（ＰＢＰＶ）治疗４～７年后的右室舒张功能，并和同期经外科瓣膜切开的ＰＳ病例相对照，从而为ＰＢＰＶ方法学选择提供中、长期随访资料。结果，ＰＢＰＶ组中Ｅ峰流速、Ｅ／Ａ流速比、Ｅ峰面积分数、Ｅ／Ａ面积比、舒张期前１／３相面积、Ｅ峰减速时间大于未经治疗组（Ｐ＜０．０１）；Ａ峰流速、Ａ峰面积分数小于未治疗组（Ｐ＜０．０１）。而在ＰＢＰＶ组与外科手术组间差异无显著意义（Ｐ＜０．０５）；在ＰＢＰＶ组中，选用球／瓣比率１．３２±０．０７及１．４９±０．０４的患儿，其右室舒张功能改善效果较为满意。结果提示，ＰＢＰＶ治疗后中、远期右室舒张功能明显改善，并与外科瓣膜切开法获得相同的效果。另外，采用球／瓣为１．３左右进行ＰＢＰＶ是值得推荐的。

Inordertoinvestigatetherightventriculardiastolicfunction(RVDF)inpatientswithpulmonicvalvestenosis(PS),westudied36casesofPSattheageof4～7yearsafterpercutaneousbaloonpulmonaryvalvuloplasty(PBPV)byusingechocardiography.Twentysurgicalytreatedpa-tientsand23untreatedpatientswereusedascontrols.TheresultsdemonstratedthatpatientsofPBPVgrouphadhigherpeakEvelocity,E/Avelocityratio,Eareafraction,0.33areafraction,longerEdecelerationtime,butlowerpeakAvelocityandAareafractionthanthoseofuntreatedgroup(P<0.01).TherewasnosignificantdiferenceintheseparametersbetweenPBPVgroupandsurgicalgroup.AbettertherapeuticefectinimprovingRVDFwasobtainedinpatientsofPBPVgroupbyusingabaloon/annalusratioofeither1.32±0.07or1.49±0.04.Themiddleandlong-termfolow-upsuggestedthatRVDFinPBPVpatientsimprovedevidently.WeconcludethatPBPVwithabaloon/annalusratioof1.3isrecommendable.