临床儿科杂志
臨床兒科雜誌
림상인과잡지
2014年
7期
610-613
,共4页
先天性心脏病%左向右分流%骨龄指数%儿童
先天性心髒病%左嚮右分流%骨齡指數%兒童
선천성심장병%좌향우분류%골령지수%인동
congenital heart disease%left to right shunt%bone age%child
目的：探讨左向右分流型先天性心脏病(CHD)，包括房间隔缺损(ASD)、室间隔缺损(VSD)、动脉导管未闭(PDA)患儿的骨龄变化以及心脏结构和功能改变与骨龄指数(BAI)的相关性。方法收集确诊左向右分流型CHD共130例，其中ASD 52例、VSD 46例、PDA 32例，超声检测各项心脏结构和功能指标，摄左手及腕关节正位片，应用最新《中国儿童骨龄评分法》图谱进行骨龄评定并计算BAI，对比分析各组骨龄以及CHD各项心脏结构和功能指标与BAI的直线相关性。结果 ASD、VSD与PDA患儿BAI的差异有统计学意义(P<0.05)；PDA组的BAI分别高于ASD组和VSD组，差异均有统计学意义(P均<0.05)。无PAH、轻度PAH以及中重度PAH三组的BAI分别为(0.84±0.09)、(0.75±0.07)和(0.65±0.08)，差异有统计学意义(F=27.77，P=0.000)；小缺损组的BAI为(0.82±0.09)，高于中大缺损组的(0.73±0.10)，差异有统计学意义(t=3.54，P=0.002)。ASD、VSD患儿缺损大小（DS）与BAI均呈负相关(r=-0.48、-0.54，P均<0.05)；ASD、VSD、PDA患儿肺动脉收缩压（PASP）以及肺循环血流量/体循环血流量比值(Qp/Qs)均与BAI呈负相关(r=-0.64~-0.38，P均<0.05)。结论左向右分流型CHD患儿的骨龄及BAI均显著落后于正常同龄儿童；左向右分流型CHD患儿骨龄落后程度与PASP、DS及分流量大小相关。
目的：探討左嚮右分流型先天性心髒病(CHD)，包括房間隔缺損(ASD)、室間隔缺損(VSD)、動脈導管未閉(PDA)患兒的骨齡變化以及心髒結構和功能改變與骨齡指數(BAI)的相關性。方法收集確診左嚮右分流型CHD共130例，其中ASD 52例、VSD 46例、PDA 32例，超聲檢測各項心髒結構和功能指標，攝左手及腕關節正位片，應用最新《中國兒童骨齡評分法》圖譜進行骨齡評定併計算BAI，對比分析各組骨齡以及CHD各項心髒結構和功能指標與BAI的直線相關性。結果 ASD、VSD與PDA患兒BAI的差異有統計學意義(P<0.05)；PDA組的BAI分彆高于ASD組和VSD組，差異均有統計學意義(P均<0.05)。無PAH、輕度PAH以及中重度PAH三組的BAI分彆為(0.84±0.09)、(0.75±0.07)和(0.65±0.08)，差異有統計學意義(F=27.77，P=0.000)；小缺損組的BAI為(0.82±0.09)，高于中大缺損組的(0.73±0.10)，差異有統計學意義(t=3.54，P=0.002)。ASD、VSD患兒缺損大小（DS）與BAI均呈負相關(r=-0.48、-0.54，P均<0.05)；ASD、VSD、PDA患兒肺動脈收縮壓（PASP）以及肺循環血流量/體循環血流量比值(Qp/Qs)均與BAI呈負相關(r=-0.64~-0.38，P均<0.05)。結論左嚮右分流型CHD患兒的骨齡及BAI均顯著落後于正常同齡兒童；左嚮右分流型CHD患兒骨齡落後程度與PASP、DS及分流量大小相關。
목적：탐토좌향우분류형선천성심장병(CHD)，포괄방간격결손(ASD)、실간격결손(VSD)、동맥도관미폐(PDA)환인적골령변화이급심장결구화공능개변여골령지수(BAI)적상관성。방법수집학진좌향우분류형CHD공130례，기중ASD 52례、VSD 46례、PDA 32례，초성검측각항심장결구화공능지표，섭좌수급완관절정위편，응용최신《중국인동골령평분법》도보진행골령평정병계산BAI，대비분석각조골령이급CHD각항심장결구화공능지표여BAI적직선상관성。결과 ASD、VSD여PDA환인BAI적차이유통계학의의(P<0.05)；PDA조적BAI분별고우ASD조화VSD조，차이균유통계학의의(P균<0.05)。무PAH、경도PAH이급중중도PAH삼조적BAI분별위(0.84±0.09)、(0.75±0.07)화(0.65±0.08)，차이유통계학의의(F=27.77，P=0.000)；소결손조적BAI위(0.82±0.09)，고우중대결손조적(0.73±0.10)，차이유통계학의의(t=3.54，P=0.002)。ASD、VSD환인결손대소（DS）여BAI균정부상관(r=-0.48、-0.54，P균<0.05)；ASD、VSD、PDA환인폐동맥수축압（PASP）이급폐순배혈류량/체순배혈류량비치(Qp/Qs)균여BAI정부상관(r=-0.64~-0.38，P균<0.05)。결론좌향우분류형CHD환인적골령급BAI균현저락후우정상동령인동；좌향우분류형CHD환인골령락후정도여PASP、DS급분류량대소상관。
Objective To investigate the changes in bone age, and the correlation between the changes in structure and function of cardiovascular and bone age index in children with left to right shunt congenital heart disease (CHD) such as atrial septal defect (ASD), ventricular septal defect (VSD) and patent ductus arteriosus (PDA). Methods One hundred and thirty children diagnosed CHD had been enrolled, including 52 cases of ASD, 46 cases of VSD and 32 cases of PDA. The cardiac structure and function indicators had been detected by ultrasonic. The anteroposterior iflm of left hand and wrist had been taken. The bone age had been assessed according to“China children bone age score”atlas, and the bone age index (BAI) had been calculated. The differences of bone age among each group had been compared. The linear correlation of the cardiac structure and function indicators with BAI had been analyzed. Results The BAI was statistically different among ASD, VSD and PDA groups (P<0.05). The BAI of PDA group was higher than those of ASD and VSD groups (all P<0.05). The BAI was also statistically different among the groups with different pulmonary artery pressures (P=0.000). The BAI was higher in small defect size group than that in large defect size group (P=0.002). The defect size was negatively correlated with BAI in both ASD and VSD groups (r=-0.48, -0.54, all P<0.05), The pulmonary artery systolic pressure and pulmonary-to-systemic blood lfow ratio (QP/QS) were negatively correlated with BAI in ASD, VSD and PDA groups (r=-0.64--0.38,all P<0.05). Conclusion The bone age and BAI of children with left to right shunt CHD are signiifcantly lower than those of healthy children of the same age . The extent of bone age delay is related with PASP, defect size and shunt volume in children with left to right shunt CHD.
