CAJ | 학술논문

目的分析成人胸段侧凸患者心脏结构和功能的特点并探讨使其发生改变的影响因素.方法回顾分析41例主弯为胸弯的成人脊柱侧凸患者的心脏彩色超声以及与脊柱侧凸相关的临床、ⅱ影像学资料,男9例,女32例;年龄22～57岁,平均31.29岁.对照组为椎间盘突出症患者35例,男7例,女28例;年龄25～44岁,平均31.17岁.研究侧凸方向、侧凸角、侧凸累及椎体数量、侧凸弧度类型、顶椎位置以及年龄对成人脊柱侧凸患者心脏结构和功能的影响.结果侧凸角和侧凸累及椎体的数量分别影响心脏舒张功能(E/A比值)和收缩功能(左室短轴缩短率).此外,侧凸弧度类型以及顶椎位置影响成人脊柱侧凸患者的主肺动脉径.成人侧凸组患者与对照组患者之间舒张末期室间隔厚度、舒张末期左室后壁厚度、舒张末期左窒前后径、收缩末期左室前后径、左房前后径、右室前后径、主动脉根径、主肺动脉径等心脏结构指标存在显著性差异.结论成人胸段侧凸患者的心脏结构和功能指标总体并未偏离正常范围,但是脊柱畸形仍对患者的心脏结构和舒缩功能产生一定影响.主要影响因素可能包括侧凸角、侧凸累及椎体数量、侧凸弧度类型以及顶椎位置.
목적 분석성인흉단측철환자심장결구화공능적특점병탐토사기발생개변적영향인소.방법 회고분석41례주만위흉만적성인척주측철환자적심장채색초성이급여척주측철상관적림상、ⅱ영상학자료,남9례,녀32례;년령22～57세,평균31.29세.대조조위추간반돌출증환자35례,남7례,녀28례;년령25～44세,평균31.17세.연구측철방향、측철각、측철루급추체수량、측철호도류형、정추위치이급년령대성인척주측철환자심장결구화공능적영향.결과 측철각화측철루급추체적수량분별영향심장서장공능(E/A비치)화수축공능(좌실단축축단솔).차외,측철호도류형이급정추위치영향성인척주측철환자적주폐동맥경.성인측철조환자여대조조환자지간서장말기실간격후도、서장말기좌실후벽후도、서장말기좌질전후경、수축말기좌실전후경、좌방전후경、우실전후경、주동맥근경、주폐동맥경등심장결구지표존재현저성차이.결론 성인흉단측철환자적심장결구화공능지표총체병미편리정상범위,단시척주기형잉대환자적심장결구화서축공능산생일정영향.주요영향인소가능포괄측철각、측철루급추체수량、측철호도류형이급정추위치.
Objective To investigate the features of the cardiac structure and function in patients with adult seoliosis. Methods The preoperative reports of cardiac ultrasound and imaging data of 41 pa-tients with adult scoliosis were retrospectively, which included 9 males, 32 females, with the mean age of 31.29 years (range, 22-57 years). Another 35 patients with intervertebral herniation were set up control group, which included 7 males, 28 females, with the mean age of 31.17 years (range, 25-44 years). Parame-ters related to cardiac structure and function were compared according to Cobb angle in coronal plane, the number of vertebrate involved, type of radian, location of the apex vertebrate and age. Results E/A value and fractional shortening were affected by the degree of the scoliosis and the number of vertebrae involved respectively. Furthermore, diameter of arteria pulmonalis was influenced by the type of radian and location of apex vertebrate. There were significant differences in interventricular septum thickness in diastole, left ven-tricular posterior wall thickness in diastole, left ventricular internal diameter in end diastole, left ventricular internal diameter in end systole, left atrial dimension, right ventricular dimension, diameter of aortic root and diameter of arteria pulmonalis between seoliosis group and control group. Conclusion Patients with adult seoliosis have no significant abnormality in cardiac structure and function. However, spinal deformities still exert certain effect on cardiac structure and function. The main factors may consist of Cobb angle in coronal plane, the number of vertebrate involved, type of radian and location of the apex vertebrate.