前列地尔辅助室间隔缺损封堵术对先天性心脏病患儿QTd、QTcd及左室电压的影响

Effect of alprostadil combined with percutaneous transcatheter closure of ventricular septal defects on QTd,QTcd,and left ventricular voltage in children with congenital heart diseases

目的探讨前列地尔辅助室间隔缺损封堵术对先天性心脏病患儿QT离散度(QTd)、矫正QTd(QTcd)、左室电压及心功能的影响。方法将138例先天性心脏病患儿随机分为对照组(单纯封堵术)和观察组(前列地尔+封堵术)各69例,比较两组患儿治疗效果的同时,对术前、给药1 d、给药5 d及治疗3个月后QTd、QTcd、左室电压、心功能及血浆氨基末端脑利钠肽前体(NT-pro BNP)变化进行分析。结果观察组治疗有效率97.2%高于对照组77.9%,两组差异有统计学意义(P<0.05)。同时,在给药5 d及治疗3个月后,观察组患儿的QTd、QTcd、Ra VL+SV3、RV5+SV1、左心室收缩期末内径、左心室收缩期末容量、左心室舒张期末内径、左心室舒张期末容量及NT-pro BNP均低于对照组患儿,差异均有统计学意义(P<0.05)。结论前列地尔辅助室间隔缺损封堵术可进一步降低先天性心脏病患儿QTd、QTcd、左室电压,改善心功能,减少NT-pro BNP分泌,从而提高治疗效果。

Objective To explore the effect of alprostadil combined with percutaneous transcatheter closure of ventricular septal defects on QT dispersion （QTd）,corrected QT dispersion （QTcd）,left ventricular voltage,and cardiac function in children with congenital heart diseases.Methods A total of 138 children with congenital heart diseases were randomly assigned to control group （occlusion only） and observation group （alprostadil combined with occlusion）,69 cases in each group.The curative effects in the two groups were compared,the changes of QTd,QTcd,left ventricular voltage,cardiac function,and plasma NT-proBNP before operation,1 day after treatment,5 days after treatment,and 3 months after treatment were analyzed.Results The effective rate in observation group （97.2%） was statistically significantly higher than that in control group （77.9%） （P〈0.05）.At the time of 5 days and 3 months after treatment,QTd,QTcd,RaVL＋SV3,RVS＋SV1,left ventricular end systolic diameter,left ventricular end systolic volume,left ventricular end diastolic diameter,left ventricular end diastolic volume,and NT-proBNP in observation group were statistically significantly lower than those in control group （P〈0.05）.Conclusion Alprostadil combined with percutaneous transcatheter closure of ventricular septal defects can further reduce QTd,QTcd,and left ventricular voltage in children with congenital heart diseases,improve cardiac function and reduce NT-proBNP secretion,then the therapeutic effect is improved.