超声观察右心容量负荷过大型先天性心脏病患儿左室舒张功能

Ultrasonic Evaluation on Left Ventricular Diastolic Function in Children with Congenital Right Ventricular Volume Overload

目的:研究右心容量负荷过大型先天性心脏病患儿左室舒张功能改变及其特点。方法:应用经胸心脏彩色多普勒超声显像仪观察28例右心容量负荷过大型先天性心脏病患儿(患儿组)的二尖瓣口血流及肺静脉血流频谱,并与20例正常儿童(正常组)作比较。结果:(1)与正常组相比,患儿组E/A值下降、ARP增高(P<0.05);两组间E峰减速时间(EDT)、左室等容舒张时间(IVRT)及肺静脉的SF比较无统计学意义(P>0.05)。(2)患儿组中46%(13/28)的E/A值为正常,其中92%(12/13)ARP比值增高。结论:右心容量负荷过大型先心病患儿左室可出现舒张功能减退;彩色多普勒检查之E/A值及ARP值异常可反映之,且后者可鉴别E/A比值伪正常化。

Objective：To study the characteristics and changes of left ventricular diastolic function in children with congenital heart disease （CHD） of right ventricular volume overload. Methods：Twenty-eight children with CHD and Twenty age-matched healthy children were recruited in this study. Their frequency spectrum of blood flow at mitral orifice and pulmonary veins were observed by color Doppler B-scanner. Results： （ 1 ） Compared with the normal control, the ratios of mitral E/A were lower, the peak velocity of pulmonary vein flow during left atrial contraction（ARP） was higher in the patients（ P 〈 0.05 ）. There was no significant difference in the decelerating time of E peak （EDT）, the isovolumic relaxation time （IVRT） and shrink fraction （SF） of pulmonary veins between two groups（ P 〉0.05 ）. （2） The normal ratios of E/A were observed on 13 patients, among them 92% （ 12/13 ） had an increased ARP value. Conclusions ：The left ventricular diastolic dysfunction could be found in the children with congenital heart disease（CHD） of right ventricular volume overload, which was reflected by the E/A ratios and ARP values that obtained from color Doppler ultrasonography, the latter could distinguish the true normal ratios of E/A from the pseudo-normalized.