拉萨和北京地区法洛四联症患者彩色多普勒超声特征对比分析

Analysis of hemodynamics by color Doppler flow imaging between patients with tefralog of Fallot Lhasa and Beijing

目的应用彩色多普勒超声心动图分析拉萨地区与北京地区法洛四联症(TOF)的特点,探讨高原与平原地区法洛四联症之间是否存在差异。方法对北京地区24例,拉萨地区16例法洛四联症患者分别进行超声心动图检查,以上患者均经手术证实为法洛四联症。分别测量主动脉骑跨率(AOR)、室间隔缺损(VSD)的大小,测量主肺动脉(MPA)内径、右房(RA)、右室横径(RV)和右室前壁(RVAW)厚度,尤其观察肺动脉狭窄的程度。结果将两组患者的各项测值进行比较,拉萨地区RA和RV明显扩大,RVAW增厚明显,MPA明显变窄,差异有显著性(P<0.05),AOR和VSD无显著性差异(P>0.05)。结论高原地区法洛四联症的超声心动图特征与高原缺氧、右心负荷明显增加之间可能存在密切相关,在高原地区患有法洛四联症的患者比平原地区患者更应早期手术为宜。

Objective To investigate the hemodynamics between patients with tetralogy of Fallot （TOF） in plateau and plain. Methods Twenty - four patients in Beijing and sixteen patients in Lhasa underwent echocardiography. The parameters measured included aortic overriding rate （AOR）, size of ventricular septal defect （VSD）, intermal diameter of main pulmonary artery （MPA）, right heart antrum （RA）, transverse diameter of right heart ventricle （RV） ,thickness of right heart ventricle anterior wall （RVAW） ,and degree of pulmonary stenosis especially.AU TOF cases were confirmed by operation. Results Compared between two groups, there were significant differences in RA,RV, RVAW,and MPA （ P 〈0.05）.In Lhasa,patients＇ RA and RV dilated, RVAW thickened,and MPA narrowed obviously.There were no significant differences in AOR and VSD （ P 〉 0.05）. Condusions The TOF features of hemodynamics in plateau may correlate with hypoxia and right ventricular pressure overload. Patients in plateau should be operated on earlier than patients in plain.