成人动脉导管未闭的UCG特点及肺动脉收缩压估测

Characteristics of adult patients with patent ductus arteriosus in ultrasonic cardiography and estimation of pulmonary pressure

目的:总结成人动脉导管未闭(PDA)的UCG特点,减少误诊和漏诊,提高肺动脉高压(PH)的检出效率。方法:选取55例成人PDA患者,分成4组:中重度PH组共27例,其中左心室内径正常组12例,左心室内径增大组15例;轻度PH组14例;无PH组14例。选取同期体检的健康成人55名为对照组。结果:各PH与无PH组比较,分流束宽、收缩期Vmax及PGs、舒张期Vmin及PGd、Vmax/Vmin差异均有统计学意义。中重度PH 95%的Vmax小于3.80 m/s,95%的Vmin小于1.75 m/s,95%的Vmax/Vmin大于2.05,95%以上的分流束大于10.74 mm。结论:成人PDA患者常合并PH,除瓣膜反流估测肺动脉收缩压(PASP)外,分流频谱的Vmax、Vmin及Vmax/Vmin可用于无创性估测PASP。

Objective： To summarize the characteristics of adult patients with patent ductus arteriosus （PDA） by ultrasonic cardiography （ UCG）, reduce misdiagnosis and missed diagnosis and improve the efficiency of pulmonary artery hypertension （PH）. Methods： Fifty-five adult PDA patients with assessed pulmonary artery systolic pressure （PASP） were divided into four groups ： 27 patients with moderate to severe PH which was consisted of left ventricular enlarged group： 15 patients and normal left ventricular diameter group： 12 patients; mild PH group： 14 patients; no PH group with 14 patients. 55 healthy adult subjects as control group. Results： Compared with no PH group, the PH groups had wider shunt beam, minor systolic Vmax and PGs/diastolic Vmin and PGdas well as major Vmax/Vmin, the differences were statistically significant. In moderate to severe pulmonary hypertension group, 95% Vmax was less than 3.80rn/s, 95% Vmin was less than 1.75m/s and 95% Vmax/Vmin greater than 2. 05. Shunt beam width greater than 5mm in all patients with PH, especially in moderate to severe PH group, more than 95% patients＇ shunt beam width greater than 10. 74mm. Conclusion： Adult PDA patients often combined with PH, indexes form shunt spectrum： Vmax, Vmin and Vmax / Vmin may be used to noninvasively estimate PH besides the way by pulmonary regurgitation and tricuspid regurgitation.