王芳,李才,周祥群
WANG Fang,LI Cai,ZHOU Xiangqun

• 1:海南省第三人民医院心血管内科
• 2:海南省第三人民医院心胸外科

摘要(Abstract)：

目的:探讨超声心动图下介入封堵术对先天性心脏病(CHD)患者右心功能的影响。方法:分析行超声心动图监测下介入封堵术的42例CHD患者(CHD组,n=42)和40例健康体检者(对照组,n=40)临床资料,比较两组受试者左心功能指标[左室射血分数(LVEF)、左室舒张末期前后径(LVEDD)、左室收缩末期前后径(LVESD)]、右心功能指标[右室舒张末/收缩末容积、右心室舒张期射血分数(RVEF)]、炎症细胞因子[白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]、血浆心钠肽(ANP)水平差异。结果:对照组LVEDD、LVESD等左心功能指标、右室舒张末容积、右室收缩末容积等右心功能指标,IL-6、CRP、TNF-α等炎症细胞因子水平及血浆ANP水平均显著低于CHD组各时段检测结果,LVEF、RVEF水平则显著高于CHD组,差异均有统计学意义(P<0.05);术后1、3个月时,CHD组LVEDD、LVESD水平,右室舒张末容积、右室收缩末容积等右心功能指标,IL-6、CRP、TNF-α等炎症细胞因子水平及血浆ANP水平均较术前显著降低,LVEF、RVEF水平则较术前显著升高,差异均有统计学意义(P<0.05)。结论:超声心动图监测下介入封堵术可有效降低CHD患者炎症反应,对调节其心功能状态及血浆ANP水平具有积极影响。
Objective:To investigate the effect of interventional closure under echocardiography on right ventricular function in patients with congenital heart disease( CHD). Methods:The clinical data of 42 patients with CHD( CHD group,n = 42) who received interventional closure under monitoring of echocardiography and 40 healthy subjects( control group,n = 40) in our hospital between April 2013 and May 2015 were retrospectively analyzed. The left ventricular function indexes [left ventricular ejection fraction( LVEF),left ventricular end diastolic diameter( LVEDD),left ventricular end systolic diameter( LVESD) ],right ventricular function indexes [right ventricular end diastolic/systolic volume,right ventricular ejection fraction( RVEF) ],levels of inflammatory cytokines [interleukin-6( IL-6),C-reactive protein( CRP),tumor necrosis factor alpha( TNF-α) ] and plasma atrial natriuretic peptide( ANP) were compared between the two groups. Results:LVEDD,LVESD,right ventricular end diastolic volume,right ventricular end systolic volume,levels IL-6,CRP,TNF-α and plasma ANP in control group were significantly lower than those in CHD group in different time periods,while LVEF and RVEF were significantly higher than those in CHD group( P < 0. 05). At postoperative 1 month and 3 months,levels of LVEDD and LVESD,right ventricular end diastolic volume,right ventricular end systolic volume,levels of IL-6,CRP,TNF-α and plasma ANP in CHD group were significantly lower than those before operation while LVEF and RVEF levels were significantly higher( P < 0. 05). Conclusions:The interventional closure under monitoring of echocardiography can effectively reduce the inflammatory reactions in patients with CHD and has a positive effect on the regulation of cardiac function and plasma ANP level.

关键词(KeyWords)： 超声心动描记术;C反应蛋白质;先天性心脏病;介入封堵术;右心功能
echocardiography;C reactive protein;congenital heart disease;interventional closure;right ventricular function

Abstract:

Keywords:

基金项目(Foundation): 三亚市院地科技合作项目(2011YD65)

作者(Author): 王芳,李才,周祥群
WANG Fang,LI Cai,ZHOU Xiangqun

DOI: 10.19367/j.cnki.1000-2707.2017.03.023

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