CAJ | 학술논문

目的利用超声斑点追踪(STI)技术对超过最佳根治年龄的室间隔完整型大动脉转位(TGA)患儿接受肺动脉环缩术(PAB)前后的左室发育进行评估,从中筛选出较为敏感的STI指标,为低龄患儿的心室功能评估提供新的指标.方法对7例年龄大于3月的超过最佳根治年龄的室间隔完整型TGA接受肺动脉环缩术(PAB组)患儿进行左室训练.8例年龄、体质量相匹配的的健康婴儿作为对照组.应用STI技术分析两组患儿左室不同水平室壁的旋转角度,左室整体扭转角度等指标.结果所有患儿接受PAB后均存活出院.术中测压提示左室和右室压力之比为(0.32±0.04):1.与对照组相比,PAB组术前射血分数、室壁厚度差异无统计学意义,但左室舒张末内径和容积显著减小.术前PAB组心底和心尖的局部旋转角度和达峰时间以及整体扭转角度与对照组显著不同.其中,术前心尖部和心底部旋转角度较对照组减小约3倍.结论左室局部的旋转和整体扭转角度的改变可能是较敏感的STI指标,可用于评价TGA患儿PAB术前心室退化以及术后心室发育的变化.
목적 이용초성반점추종(STI)기술대초과최가근치년령적실간격완정형대동맥전위(TGA)환인접수폐동맥배축술(PAB)전후적좌실발육진행평고,종중사선출교위민감적STI지표,위저령환인적심실공능평고제공신적지표.방법 대7례년령대우3월적초과최가근치년령적실간격완정형TGA접수폐동맥배축술(PAB조)환인진행좌실훈련.8례년령、체질량상필배적적건강영인작위대조조.응용STI기술분석량조환인좌실불동수평실벽적선전각도,좌실정체뉴전각도등지표.결과 소유환인접수PAB후균존활출원.술중측압제시좌실화우실압력지비위(0.32±0.04):1.여대조조상비,PAB조술전사혈분수、실벽후도차이무통계학의의,단좌실서장말내경화용적현저감소.술전PAB조심저화심첨적국부선전각도화체봉시간이급정체뉴전각도여대조조현저불동.기중,술전심첨부화심저부선전각도교대조조감소약3배.결론 좌실국부적선전화정체뉴전각도적개변가능시교민감적STI지표,가용우평개TGA환인PAB술전심실퇴화이급술후심실발육적변화.
Objective To identify the suitable echocardiographic predictor of speckle tracking imaging (STI) for evaluation of development of left ventricle(LV) after pulmonary artery banding (PAB).Methods Seven children older than 3 months with transposition of great arteries with intact ventricular septum (TGA) were enrolled,they received pulmonary artery banding (PAB group).Eight body surface area matched healthy children were severed as control group.Using the STI technique,the rotation curves at apex and base were analyzed.Results All the patients discharged eventually.The intraoperative LV/RV systolic pressure ratio in PAB group was (0.32 ± 0.04):1.There were no differences in ejection fraction and wall thickness between control and PAB group.However,the end diastolic diameter and end diastolic volume in PAB group was significantly reduced.Compared with the control group,the hypoplasia of LV in PAB group was associated with an extended time to peak basal rotation,and furthermore,the basal and global torsion was significantly reduced by 3 times.Conclusions STI showed local rotation and global torsion might be thevaluable predictor to evaluate the regressed and the development of LV peri-PAB procedure for the older children with TGA.