CAJ | 학술논문

目的：探讨成功介入封堵治疗的室间隔缺损（VSD ）在封堵前后即刻、随访期肺动脉压力的变化规律。方法650例成功施行介入治疗的VSD患者，经导管测定术前及封堵后即刻肺动脉压力，并于介入术前当日、术后3d、1、3、6个月分别应用超声心动图测定肺动脉压力并进行对比。结果肺动脉收缩压（PASP）和肺动脉平均压（PAMP）超声和心导管测值均显著正相关：（1）正常肺动脉压力组：PASP和PAM P在封堵即刻后及随访期差异均无统计学意义。（2）轻度肺高压组：PASP在封堵即刻后无明显变化，6个月时与封堵前后比较均显著下降（P＜0．05）。PAMP在封堵即刻后升高，术后1个月及6个月与封堵后比较均显著降低（P＜0．05）。（3）中度肺高压组：PASP及PAMP在封堵即刻后均显著降低（P＜0．05），两者在术后3 d 及随访中与封堵前比较进行性降低（P＜0．05）；PASP在术后1、3、6个月较封堵后降低（P＜0．05）。结论经导管封堵治疗能明显降低VSD合并轻、中度肺动脉高压患者肺动脉压力，近、中期疗效确切。
목적：탐토성공개입봉도치료적실간격결손（VSD ）재봉도전후즉각、수방기폐동맥압력적변화규률。방법650례성공시행개입치료적VSD환자，경도관측정술전급봉도후즉각폐동맥압력，병우개입술전당일、술후3d、1、3、6개월분별응용초성심동도측정폐동맥압력병진행대비。결과폐동맥수축압（PASP）화폐동맥평균압（PAMP）초성화심도관측치균현저정상관：（1）정상폐동맥압력조：PASP화PAM P재봉도즉각후급수방기차이균무통계학의의。（2）경도폐고압조：PASP재봉도즉각후무명현변화，6개월시여봉도전후비교균현저하강（P＜0．05）。PAMP재봉도즉각후승고，술후1개월급6개월여봉도후비교균현저강저（P＜0．05）。（3）중도폐고압조：PASP급PAMP재봉도즉각후균현저강저（P＜0．05），량자재술후3 d 급수방중여봉도전비교진행성강저（P＜0．05）；PASP재술후1、3、6개월교봉도후강저（P＜0．05）。결론경도관봉도치료능명현강저VSD합병경、중도폐동맥고압환자폐동맥압력，근、중기료효학절。
Objective To compare the changes of pulmonary artery pressure (systolic pulmonary pressure ,PASP ;mean pulmonary pressure ,PAMP) before and after transcatheter occlution in pa-tients with ventricular septal defect (VSD) .Methods Total of 650 patients with VSD underwent tran-scatheter closure were involved in this study .The parameters of pulmonary artery pressure including PASP and PAMP were evaluated with cardiac catheter before and after procedures .Transthoracic ech-ocardiography examination performed at 3 days after procedures and during follow-up of next 1 ,3 and 6 months .Results There were significantly relationship between the pulmonary arterial pressure from Doppler echocardiography examination and cardiac catheter examination before transcatheter occlusion in patients with VSD (PASP :r=0 .810 ,P<0 .05 ;PAMP :r=0 .819 ,P<0 .05 .Pearson) .In normal group ,PASP had not significant changes .PAMP increased at 3 months from the operation .In mild pulmonary hypertension group ,PASP and PAMP increased immediately after operation ,which de-creased apparently at 6 months .In moderate pulmonary hypertension group ,PASP and PAMP de-creased apparently immediately after the operation .The pulmonary pressure had been decreasing dur-ing the following 6 months .Conclusion Transcatheter closure of VSD with mild or moderate pulmona-ry hypertension is safe and effective .