Objective To reevaluate the accuracy and effect factors of systolic pulmonary artery pressure (SPAP) of atrial septal defect (ASD) calculated through tricuspid regurgitation pressure gradient (TRPG) by ultrasonic cardiogram (UCG). Methods Totally 45 ASD sufferers who were ready to undergo interventional device closure were enrolled in this study. SPAP and superior vena caval mean pressure ( see as mean right atrial pressure ) were measured by right heart catheterization(RHC) , while TRPG and right atrium inside diameter were measured by UCG simultaneously and within 24 hours before the operation. Statistics were performed using SPSS software. Results Compare to RHC, the sensitivity of the TRPG method to screen the pulmonary hypertension was 67% and the specificity was 72%. The accuracy of the grading of pulmonary artery pressure calculated by TRPG method was low (the area under the ROC curve was 0. 603). The inaccurate ratio and degree of the TRPG were higher than the RAP. There were differences between preop-erative and intraoperative measured value of SPAP calculated by UCG because of the inaccuracy of TRPG. Conclusion The small sample study indicated that the accuracy of systolic pulmonary artery pressure calculated through tricuspid regurgitation pressure gradient method by echocardiogram in ASD was low, and the TRPG showed higher effect on SPAP than the RAP.%目的 对三尖瓣反流压差法定量房间隔缺损肺动脉收缩压的准确性及其影响因素进行再评估.方法 对行介入封堵术的房间隔缺损患者45例于术前24小时和封堵前即刻行三尖瓣反流压差、右房内径等超声数据采集；封堵前即刻记录右心导管所测量的肺动脉收缩压和上腔静脉平均压(作为右房平均压).对所采集数据进行统计学分析.结果 术中三尖瓣反流压差法计算的肺动脉收缩压与右心导管测值相比用以筛选肺动脉高压敏感性为67％,特异性为72％,判断肺动脉压力等级的准确性较低(ROC曲线下面积为0.603).三尖瓣反流压差出现不准确的比例及程度较右房压大.术前与术中应运用三尖瓣反流压差法计算肺动脉收缩压存在一定的差异,且与三尖瓣反流压差有关.结论 小样本研究发现三尖瓣反流压差法定量房间隔缺损肺动脉收缩压准确性较低,三尖瓣反流压差较右房压对最终结果的影响更大.
展开▼
