房间隔缺损手术前后使用实时三维超声心动图评估右心功能的临床研究

Clinical study of right heart function assessment with real-time three-dimensional echocardiography before and after atrial septal defect surgery

目的:研究房间隔缺损手术前后使用实时三维超声心动图评估右心功能的临床价值。方法:选择在我院接受经导管介入封堵术治疗的房间隔缺损患者进行研究,根据肺动脉收缩压(PASP)分为非肺动脉高压组、肺动脉高压组,手术前后进行实时三维超声心动图检查,计算右心室舒张末容积(RVEDV)、右心室收缩末容积(RVESV)、右心室每搏输出量(RVSV)、右心室射血分数(RVEF)、右心室输出量(RVCO);采集血清检测脑钠肽(BNP)、心房利钠肽(ANP)、血管紧张素I(AngI)、血管紧张素II(AngII)、内皮素(ET)含量。结果:手术后,两组RVEDV、RVESV、RVSV、RVEF、RVCO以及血清BNP、ANP、AngI、AngII、ET含量均低于术前;RVEDV、RVESV、RVSV、RVEF、RVCO与BNP、ANP、AngI、AngII、ET的含量呈正相关。结论:房间隔缺损手术前后使用实时三维超声心动图能够准确评估右心功能,与右心容量负荷、肺循环血流状态具有良好的相关性。

Objective： To study the clinical value of right heart function assessment with real-time three-dimensional echocardiography before and after atrial septal defect surgery. Methods： Patients with atrial septal defect who received transeatheter closure in our hospital were selected and divided into non-pulmonary hypertension group and pulmonary hypertension group according to pulmonary artery systolic pressure （PASP）, real-time three-dimensional echocardiography was conducted before and after undergoing operation, and right ventricular end-diastolic volume （RVEDV）, right ventricular end-systolic volume （RVESV）, right ventricular stroke volume （RVSV）, right ventricular ejection fraction （RVEF） and right ventricular cardiac output （RVCO） were calculated; serum was collected, and brain natriuretie peptide （BNP）, atrial natriuretie peptide （ANP）, angiotensin I （AngI）, angiotensin II （AngII） and endothelin （ET） contents were detected. Results.. After undergoing surgery, RVEDV, RVESV, RVSV, RVEF and RVCO as well as serum BNP, ANP, AngI, AngII and ET contents of both groups were lower than those before treatment; RVEDV, RVESV, RVSV, RVEF and RVCO were positively correlated withcontents of BNP, ANP, Angl, AnglI and ET. Conclusion： Using real-time three-dimensional echocardiography before and after atrial septal defect surgery can accurately assess right heart function, and it has good correlation with right heart volume load and pulmonary circulation blood flow.