%0 Journal Article
%T 三尖瓣环收缩期位移评价先天性心脏病相关肺动脉高压疾病严重程度的价值
%A 孙行行
%A 吴文汇
%A 袁平
%A 刘锦铭
%J 同济大学学报(医学版)
%D 2018
%R 10.16118/j.1008-0392.2018.04.011
%X 目的 观察先天性心脏病相关肺动脉高压（pulmonary arterial hypertension with congenital heart disease, CHD-PAH）患者超声心动图参数，分析三尖瓣环收缩期位移（tricuspid annular plane systolic excursion, TAPSE）评价疾病严重程度的价值。方法 回顾性分析2011年10月—2017年7月住院患者74例，28例曾行修补手术治疗的患者作为修补组，其余46例作为未修补组。所有患者均行超声心动图检测，分别将修补组和未修补组患者根据世界卫生组织心功能分级（World Health Organization functional class, WHO-FC）分为Ⅰ~Ⅱ级亚组和Ⅲ~Ⅳ级亚组，观察TAPSE差异。结果 与未修补组相比，修补组氨基末端脑利钠肽前体（N-terminal natriuretic peptide type-B, NT-proBNP）较高（P<0.05），肺血管阻力（pulmonary vascular resistance, PVR）较高（P<0.05）,超声心动图参数TAPSE较低（P<0.05）。根据WHO-FC将未修补及修补患者分别为2个亚组（WHO-FC Ⅰ/Ⅱ及Ⅲ/Ⅳ组）： 在未修补的亚组中，TAPSE在WHO-FC不同分级中差异无统计学意义（P>0.05），且TAPSE趋于正常；而在修补后的亚组中，TAPSE随着WHO-FC分级的逐渐增加而降低(P<0.05)，且低于正常值。但修补与未修补两亚组的TAPSE与NT-proBNP（r=-0.30,P>0.05;r=0.24,P>0.05）及PVR(r=-0.21,P=0.16;r=-0.24,P=0.12)均没有相关性。结论 对于CHD-PAH患者，无论是修补组还是未修补组，TAPSE可能均不能准确的评估患者疾病的严重程度。</br>Objective To examine the value of tricuspid annular plane systolic excursion (TAPSE) for evaluation of severity of pulmonary arterial hypertension in patients with congenital heart disease (CHD-PAH). Methods Clinical data of 74 CHD-PAH patients admitted in Shanghai Pulmonary Hospital from October 2011 to July 2017 were enrolled in the study. Among 74 patients 28 cases received open cardiac surgery for repairing the congenital defects (repaired group) and remaining 46 cases did not receive the repairing surgery (unrepaired group). All patients underwent echocardiography examination and according to World Health Organization functional class (WHO-FC), patients were further divided into grade Ⅰ-Ⅱ and grade Ⅲ-Ⅳ groups. The TSPSE values were compared between groups. Results The repaired group had a significantly lower TAPSE and higher NT-proBNP and pulmonary vascular resistance (PVR) levels than unrepaired group (P<0.05). There was a significantly difference in TAPSE between WHO-FC Ⅰ/Ⅱ and Ⅲ/Ⅳ subgroups in repaired patients (P<0.05); while the TAPSE was normal in unrepaired group and there no significant difference between the subgroups. TAPSE in repaired and unrepaired groups was not correlated with NT-proBNP（r=-0.30, P>0.05; r=0.24, P>0.05）and PVR (r=-0.21, P=0.16;r=-0.24, P=0.04). Conclusion TAPSE may not have the value for assessment of disease severity in repaired or unrepaired patients with congenital heart disease with pulmonary arterial hypertension
%K 先天性心脏病 肺动脉高压 超声心动图 三尖瓣环收缩期位移&lt
%K /br&gt
%K congenital heart disease pulmonary arterial hypertension echocardiography tricuspid annular plane systolic excursion
%U http://tjyxxb.cnjournals.cn/ch/reader/view_abstract.aspx?file_no=20180411&flag=1