超声心动图预测先天性心脏病相关性肺动脉高压患者参数的价值

摘要

目的：评价超声心动图预测先天性心脏病相关性肺动脉高压患者肺循环参数的临床价值。方法选择2011年3月至2014年3月收治的38例肺动脉高压患者，21例有先天性心脏病，17例无先天性心脏病。经胸超声心动图（TTE）及心导管测量肺循环参数，同时应用 Fick 法、TTE 测定心输出量（CO），比较二者之间的关系。结果肺动脉压力测量值，无论有无先天性心脏病，TTE 法测量值与心导管法测量值均有相关性，无先天性心脏病患者的相关性高于有先天性心脏病患者的相关性，两者比较差异均未见统计学意义。心输出量测量值，TTE法与 Fick 法之间的相关性，无先天性心脏病患者高于有先天性心脏病患者；有先天性心脏病患者的 CO、TTE 与Fick 法测量值之间的曲线回归模型比较差异未见统计学意义，而无先天性心脏病患者差异有统计学意义。结论 TTE可以用来预测肺动脉高压患者的肺动脉压力，预测先天性心脏病相关性患者的肺动脉压力的准确性低于无先天性心脏病患者的肺动脉压力；在估测心输出量时需慎重，尤其是存在先天性心脏病时。%Objective To evaluate the clinical value of echocardiography in predicting the pa-rameters of pulmonary arterial hypertension( PAH ) in patients with congenital heart disease. Methods From March 2011 to March 2014,38 patients with PAH hospitalized were selected, 21 patients with congenital heart disease and 17 patients without congenital heart disease. Pulmonary hemodynamic parameters were measured by transthoracic echocardiography( TTE ) and right catheterization(RCH)examination. Cardiac output(CO)were obtained with Fick’s principle and TTE. Results Pulmonary arterial pressures(PAP)by TTE and RCH were more correlative in patients without congenital heart disease than in patients with congenital heart disease. The CO by TTE and Fick’s principle,and were more correlative in patients without congenital heart disease than in patients with congenital heart disease. However,regression models of CO by TTE and Fick’s principle in patients with congenital heart disease were not significantly different and in patients without congenital heart disease were significantly different. Conclusions TTE can more accurately predict the PAP in patients without congenital heart disease than in patients with congenital heart disease,caution is needed to estimate cardiac output,especially for patients with congenital heart disease.