魏鑫,王琦光,王健铭,朱鲜阳,张端珍,庚靖淞,张宇静

• 1:北部战区总医院先心病内科
• 2:沈阳市第一人民医院心血管内科

摘要(Abstract)：

目的探讨不同年龄段房间隔缺损患者经皮封堵术后心脏重构的变化过程。方法收集2015年8月至2019年10月在北部战区总医院先心病内科成功接受经皮房间隔缺损封堵术治疗的患者211例,按患者年龄分为3组:A组(年龄<18岁,50例)、B组(18～40岁,79例)、C组(年龄>40岁,82例)。应用经胸超声心动图测量指标:右心房内径、右心室舒张末期内径、左心房内径、左心室舒张末期内径,观察患者术后第2天、术后1个月、术后3个月、术后6个月较术前的变化情况。结果各年龄组患者术后右心房内径(F=50.48,P<0.05)、右心室内径均减小(F=60.00,P<0.05),左心室舒张末期内径增大(F=15.72,P<0.05),左心房内径无明显变化(F=1.59,P>0.05)。各年龄组患者术后第2天即可出现显著的心脏重构,此过程于术后1个月变化趋于平缓。A组患者术后第2天右心房内径即明显减小[(32.78±6.68)mm比(29.36±5.54)mm,P<0.05],这种变化趋势持续到术后1个月,仍可观察到上述指标的进一步减小,与术后第2天相比差异有统计学意义[(29.36±5.54)mm比(27.06±5.60)mm,P<0.05]。术后3个月时右心房内径仍有减小,但差异较术后1个月无统计学意义[(27.06±5.60)mm比(26.89±5.13)mm,P>0.05],此后右心房内径变化不明显。右心室内径与右心房内径变化过程相似。而左心室舒张末期内径主要表现为逐渐增大,术后6个月时左心室舒张末期内径已经由(35.32±5.56)mm增到(37.91±5.44)mm。B组、C组术后各心腔内径变化趋势与A组类似,均在术后早期即可出现明显心脏重构,此过程持续约1个月后逐渐趋于平缓。结论各年龄段的房间隔缺损患者封堵术后早期均可发生明显心脏重构,此过程随时间延长趋于平稳。不同年龄的房间隔缺损患者术后右心室重构能力不同,随年龄增加降低。因此符合封堵术适应证的患者,均应尽早行手术治疗。

关键词(KeyWords)： 房间隔缺损;介入治疗;心脏重构;年龄

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 魏鑫,王琦光,王健铭,朱鲜阳,张端珍,庚靖淞,张宇静

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