连续波多普勒与心电图对儿童肺动脉瓣狭窄程度的评估

Estimating Pulmonary Aortic Stenosis in Children by Continuous Wave Doppler and Electrocardiogram

目的对于儿童肺动脉狭窄(PS)程度的准确评估可为治疗方法的选择提供重要依据。本文探讨应用无创连续波多普勒(CW)和心电图(ECG)分别估测儿童PS程度的准确性。资料与方法收集2012年1月-2016年8月沈阳军区总医院收治的60例孤立性PS患儿。通过CW测量跨肺动脉压力阶差估测右心室压力;通过ECG测量V1R波振幅高度估测右心室压力。分别与心导管测量右心室压力进行比较。结果采用CW测量跨肺动脉压力阶差估测所得右心室压力与心导管测量值呈正相关(r=0.88,P<0.05);采用ECG V1R波振幅高度估测所得右心室压力与心导管测量值呈正相关(r=0.83,P<0.05)。结论 CW与ECG分别估测右心室压力与心导管测量结果均密切相关,CW及ECG估测右心室压力与心导管测量右心室压力一致性较好,均可作为估测儿童PS程度的无创检查方法。

Purpose Estimation of the degree of pulmonary artery stenosis （PS） in children patients before treatment can provide an important basis for the choice of treatment. This study explores the accuracy ofnon-invasive continuous wave Doppler （CW） and electrocardio- gram （ECG） in estimating the degree of PS in children patients. Materials and Methods Sixty consecutive cases of PS children were collected from January 2012 to August 2016 in the General Hospital of Shenyang Military. The right ventricular pressure was estimated by measuring cross-pulmonary artery pressure gradient by CW. or estimated by measuring the amplitude of the V＆R wave by ECG, which was then compared with that measured by cardiac catheterization respectively. Results The right ventricular pressure estimated by measuring cross-pulmonary artery pressure gradient by CW was positively correlated with that measured by cardiac catheterization （t-0.88, P〈0.05）. The right ventricular pressure estimated by measuring the amplitude of the V＆R wave by ECG was also positively correlated with that measured by cardiac catheterization （r=0.83, P〈0.05）. Conclusion The right ventricular pressure estimated by CW or ECG has good consistency with that measured by cardiac catheterization. Both CW and ECG can be used as noninvasive methods for estimating the degree of PS in children.