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目的:研究经皮动脉导管未闭(PDA)介入封堵术对心脏结构和心肌作功(Tei)指数的影响。方法:PDA经导管封堵后的患者16例,并选择年龄相当的16例健康人作为对照组,应用超声心动图测定左、右心室Tei指数、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)和主动脉瓣血流速度峰值(Vp)等指标。结果:①PDA封堵成功率100%,封堵成功的患者均于术前、术后2 d及3个月行经胸超声心动图检查和随访,均无残余分流和并发症,生活质量良好。②PDA患者术前左心室Tei指数较对照组显著升高(P<0.01),术后2 d左心室Tei指数较术前显著升高(P<0.01),术后3个月左心室Tei指数恢复到正常范围内,PDA患者封堵术前后右心室Tei指数变化差异无统计学意义(P>0.05)。③PDA封堵前左心房内径、LVEDD、LVESD、LVFS、LVEF、Vp均较对照组明显增大(P<0.05或P<0.01),术后2 d均明显减小(P<0.05或P<0.01),术后3个月恢复到正常范围内。PDA封堵后右心室舒张末期内径未见明显改变(P>0.05)。④PDA封堵术后Tei指数的变化与LVEDD、LVEF、Vp的变化均呈显著负相关(均P<0.05),与相应的R-R间期的变化无显著相关性。结论:①介入封堵治疗后PDA患者Tei指数短期内均显著升高,于术后3个月恢复正常。②短期内Tei指数的变化与LVEDD、LVEF、Vp的变化呈负相关,Tei指数可以作为反映心功能变化的可靠的指标。
Objective: To study the effects of percutaneous catheter catheterization (PDA) on the cardiac structure and cardiac function (Tei) index. Methods: Totally 16 patients with PDA after catheter occlusion were selected and 16 healthy individuals of the same age were selected as the control group. The left and right ventricular Tei index, left ventricular end-diastolic dimension (LVEDD), left ventricular systolic pressure (LVESD), left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS) and aortic valve peak velocity (Vp) and other indicators. Results: ① The successful rate of PDA occlusion was 100%. All the patients with successful occlusion underwent echocardiography and follow-up 2 and 3 months after operation. There were no residual shunts and complications and the quality of life was good. (2) The Tei index of left ventricle in patients with PDA was significantly higher than that in control group (P <0.01), and the Tei index of left ventricle was significantly increased 2 d after operation (P <0.01). The left ventricular Tei index recovered 3 months after operation Within the normal range, there was no significant difference in Tei index of right ventricular before and after closure in PDA patients (P> 0.05). (3) The diameter of left atrium, LVEDD, LVESD, LVFS, LVEF and Vp before PDA occlusion were significantly higher than those in control group (P <0.05 or P <0.01) ), 3 months after surgery returned to normal range. There was no significant change in the end-diastolic diameter of right ventricle after PDA occlusion (P> 0.05). There was a significant negative correlation between Tei index and changes of LVEDD, LVEF and Vp after PDA closure (all P <0.05), but not with the corresponding R-R interval. Conclusion: ① After interventional treatment, the Tei index of PDA patients increased significantly in short term and recovered to normal level 3 months after the operation. ② The change of Tei index in the short term is negatively correlated with the changes of LVEDD, LVEF and Vp, and the Tei index can be used as a reliable indicator to reflect the change of cardiac function.