不同年龄儿童左冠状动脉异常起源于肺动脉的超声心动图比较

摘要

目的：总结ALCAPA患者的超声心动图特点，比较不同年龄段患儿ALCAPA的超声心动图特征。方法回顾性研究在我院行超声心动图检查诊断ALCAPA患儿共71例。根据年龄将本研究对象分成婴儿组（年龄≤1岁）40例，年长儿组（年龄＞1岁）31例，对两组超声参数进行比较。结果左冠状动脉于肺动脉内开口显示率及左冠状动脉内逆向血流信号显示率，两组间无明显差异（ P ＞0．05）；婴儿组左心室扩张程度较年长儿组更明显、左心室收缩功能明显减弱、左右冠状动脉间形成的侧枝血管明显减少（ P均＜0．001）；年长儿组右冠状动脉内径较婴儿组宽（ P ＜0．05）；二尖瓣反流严重程度两组无明显差异（ P ＞0．05）。结论掌握不同年龄段ALCAPA小儿的超声心动图特点，能进一步提高超声对该病的诊断率。%Objective To summarize echocardiographic features of anomalous origin of the left coronary artery from the pulmo -nary artery (ALCAPA) and to compare the echocardiographic characteristics in children of different age .Methods The echocar-diographic records of 71 cases with ALCAPA were reviewed retrospectively .Patients were divided into infant group ( n=40 ) and older group ( n=31 ) using the age of 1 year as borderline .The echocardiographic parameters were compared between the two groups .Results Looking at the rate of visualization of the anomalous origin of the left coronary artery and the rate of visualization of the retrograde flow in the left coronary artery , there were no significant difference between the infant group and older group . Compared with the older group , infant group patients had more severe left ventricle ( LV) dilation, poorer cardiac function and less intercoronary collateral vessels (all P <0.001).The right coronary artery in older group was wider than that in infant group ( P <0.05).No significant difference of degree of mitral regurgitant was found between the two groups ( P >0.05).Conclu-sion Based on the apprehension of echocardiographic clues in children of different age , echocardiography can reveal ALCAPA accurately.