左向右分流型先天性心脏病患儿肺功能相关研究

摘要

Objective To investigate the correlation of the parameters of pulmonary function test in children with left-to-right shunt congenital heart disease, and study the interaction of eardiopulmonary function. Methods Sixty two children with congenital heart disease and 40 healthy children, as control group, were selected. The lung function, blood gas analysis (PaO2、 PaC02 、pH) and C-reaction protein were tested and the correlations were analyzed. Results Respiratory rate in congenital heart disease group was higher than that in control group. Tidal volume per kilogram (VT/kg) , peak tidal expiratory flow (PTEF) , ratio of time to peak tidal expiratory flow to total expiratory time (TPTEF/Te) , ratio of volume to peak expiratory flow to total expiratory volume (VPEF/Ve) were all lower in congenital heart disease group than those in control group. Respiratory rate level increased and VT/kg, PTEF, TPTEF/ Te and VPEF/Ve decreased gradually in conditions of simple congenital heart disease, congenital heart disease with pneumonia, and congenital heart disease and heart failure with pneumonia. Compared with control group, PaO2 level in simple congenital heart disease, congenital heart disease with pneumonia, congenital heart disease and heart failure with pneumonia groups gradually reduced, while C-reaction protein levels increased progressively. Conclusions Pulmonary function testing can reflect the features of pathophysiology of heart and lung function in children with the left-to-right shunt congenital heart disease, blood gas analysis and serum C-reaction protein can reflect the severity of the disease.%目的 探讨左向右分流型先天性心脏病患儿心肺功能的交互作用.方法 选择左向右分流型先天性心脏病患儿62例为先心组,健康体检儿童40例为对照组,进行肺功能检查与血气分析(PaO2、PaCO2、pH值)及血C-反应蛋白(CRP)测定,并进行相关性分析.结果 先心组患儿的呼吸频率(RR)高于对照组,每千克体质量潮气量( VT/kg)、潮气呼吸峰流速(PTEF)、达到峰流速的时间与呼吸时间的比值(TPTE F/Te)、达到呼气峰流速时呼出的气体容积与呼气容积的比值(VPEF/Ve)水平均低于对照组；从单纯先天性心脏病到先天性心脏病合并肺炎、到合并肺炎与心力衰竭,RR水平越来越高,VT/kg、PTEF、TPTEF/Te、VPEF/Ve水平则越来越低；单纯先天性心脏病,先天性心脏病合并肺炎、合并肺炎与心力衰竭患儿与对照组比较,PaO2水平逐渐降低,CRP水平逐渐升高.结论 肺功能测定能够反映左向右分流型先天性心脏病患儿心肺功能的病理生理特点,血气分析及血CRP测定能反映患儿疾病的严重程度.