腺样体肥大儿童的隐匿性心血管改变

Asymptomatic cardiovascular changes in children with adenoid hypertrophy

目的探讨腺样体肥大儿童的隐匿性心血管改变。方法分析120例腺样体肥大患儿术前x线胸片、心脏彩超检查结果，于术后6个月复查心脏彩超并与术前比较。结果术前所有患儿心胸比均正常，但肺动脉压升高[（22．6±3．6）nlnlHg，1mmHg=0．133kPa]，A峰E峰流速比值减小（1．01±0．17），右室舒张末内径增加[（1．88±0．18）cm]。术后6个月，肺动脉压降低至（17．1±3．2）mmHg，A峰E峰流速比值升高至1．25±0．12，右室舒张末内径降低至（1．67±0．11）cm。手术前后各指标改变差异有统计学意义（P〈0．05）。结论腺样体肥大可引起儿童心血管隐匿性改变，及早治疗可以预防发生严重心肺并发症。

Objective To detect the asymptomatic cardiovascular changes in children with adenoid hypertrophy. Methods One hundred and twenty children with adenoid hypertrophy underwent both chest X-ray and echocardiography before adenoidectomy, and echocardiography 6 months after operation. Results No child showed an increase in the cardiothoracic ratio on X-ray. But preoperative echocardiography showed an increase in pulmonary artery pressure E （ 22. 6 ± 3.6 ） mm Hg, 1 mm Hg = 0. 133 kPa 3, a decrease in E/A （1.01 ± 0. 17 ）, and an increase in right ventricular end-diastolic diameters [ （ 1.88 ± 0. 18 ） cm ]. While after operation,pulmonary artery pressure decreased to（ 17.1 ± 3.2） mm Hg,E/A increased to 1.25 ± 0. 12, and right ventricular end-diastolic diameters decreased to （ 1.67 ± 0. 11 ） cm. Each index change before and after operation was statistically significant （ P 〈 0. 05 ）. Conclusion Adenoid hypertrophy can result in clinically a- symptomatic cardiopulmonary changes. Early diagnosis and treatment of this disease can prevent serious cardiopulmonary complications.