先天性心脏病患儿心胸比与心功能的相关性研究

Correlation between Cardiothoracic Ratio and Cardiac Function in Children with Congenital Heart Disease

目的探究先天性心脏病(CHD)患儿心胸比与心功能的相关性。方法选取2016年1月—2019年6月收治的48例CHD患儿作为CHD组。收集患儿临床资料,根据心胸比将48例患儿分为心胸比正常组28例和心胸比异常组20例。同时选取50例健康婴幼儿作为对照组。采用心脏超声测定所有研究对象的心胸比、左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)、二尖瓣口E/A比值、三尖瓣血流速度、三尖瓣反流面积等。采用受试者工作特征(ROC)曲线分析心胸比对心功能不全的预测价值。结果CHD组的心胸比、三尖瓣血流速以及三尖瓣反流面积均显著高于对照组,LVEF水平显著低于对照组(P<0.05)。心胸比异常组的心胸比、三尖瓣血流速以及三尖瓣反流面积均显著高于心胸比正常组和对照组,LVEF、LVFS及E/A比值均显著低于心胸比正常组和对照组(P<0.05)。心胸比正常组与对照组的上述指标比较差异均无统计学意义(P>0.05)。心胸比诊断心功能不全的ROC曲线下面积为0.837,临界值为0.523,敏感度和特异性分别是86.4%和88.5%。结论婴幼儿心胸比增大时心功能可能变差,可辅助用于CHD患儿心功能不全的预测评估。

Objective To explore the correlation between cardiothoracic ratio(CTR)and cardiac function in children with congenital heart disease(CHD).Methods Forty-eight children with CHD admitted from January 2016 to June 2019 were selected as the CHD group.Clinical data of the children was collected,and 48 children were divided into the normal CTR group(n=28)and the abnormal CTR group(n=20)according to the CTR.In the meantime,50 healthy children were selected as the control group.Echocardiography was used to measure the CTR,left ventricular ejection fraction(LVEF),left ventricular fractional shortening(LVFS),mitral orifice E/A ratio,tricuspid flow velocity,and tricuspid regurgitation area.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of CTR for cardiac insufficiency.Results The CTR,tricuspid flow velocity and tricuspid regurgitation area of the CHD group were significantly higher than those of the control group,while the LVEF level was significantly lower than that of the control group(P<0.05).The CTR,tricuspid flow velocity and tricuspid regurgitation area of the abnormal CTR group were significantly higher than those of the normal CTR group and the control group,while the LVEF,LVFS and E/A ratios were significantly lower than those of the normal CTR group and the control group(P<0.05).There were no statistically significant differences in the above indicators between the normal CTR group and the control group(P>0.05).The area under the ROC curve was 0.837,the critical value was 0.523,and the sensitivity and specificity were 86.4%and 88.5%respectively.Conclusion The cardiac function may become worse when the CTR is larger in infants,which can be used to predict and evaluate the cardiac dysfunction in children with CHD.