摘要
目的探讨中老年先天性心脏病并发肺动脉高压（PAH）患者的临床特点。方法选择先天性心脏病并发PAH患者177例，根据年龄分中年组（124例）和老年组（53例）。回顾性分析两组患者的临床资料。结果两组患者无症状（16．9％ vs 5．7％）、无体征（39．5％vs17．0％）、气急（41．9％vs66．0％）、颈静脉显露（6．5％vs18．9％）、下肢水肿（25.8％vs64．2％），差异显著（P〈0．01），胸部X线显示心影增大（44．4％vs64．2％）、心房颤动（12．1％vs35．8％）、超声心动图测左右心房最大容积、右心室舒张末期容积、肺主动脉内径及双向分流（11．3％vs30．2％）、二尖瓣反流（19．4％vs49．1％）、心包积液发生率（5．6％vs22．6％）均高于中年组。结论老年组患者心脏结构及功能改变较中年组患者突出。介入治疗是中老年先天性心脏病并发PAH患者的主要治疗方法，成功率高。
Objective To investigate the clinical features of congenital heart disease（CHD） complicated with pulmonary arterial hypertension（PAH） in middle-aged and aged people. Methods A total of 177 cases of CHD complicated with PAH Over 40 years old were selected from 3 674 CHD patients. They were divided into middle-aged adult group（〈60）and aged adult group（≥60）. The data of the two groups were analyzed retrospectively. Results Both groups were mainly made up of female and atrial septal defect（ASD） patients. In middle-aged group, more patients were asymptomatic and had no special physical sign, while in aged group,dyspnea,jugular vein distension, edema of lower extremities and atrial fibrillation were more common and NYHA grade was higher than the middle-aged group. The transthoraeic echoeardiography revealed larger volumes of both atria and right ventricle, and diameter of main pulmonary artery in the aged. Incidences of bidirectional shunt, mitral regurgitation and perieardiac effusion were also higher in the aged group. Most patients accepted transcatheter closure of defect in both groups（89.5 % vs 77.4 %）. Conclusions The aged patients have more predominant changes in cardiac structure and function than the middle-aged ones. Transeatheter closure of defect is the main treatment for patients over middle age with CHD and PAH,and has been proved to be safe and successful.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2008年第12期899-901,共3页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
心脏缺损
先天性
高血压
肺性
心房颤动
heart defects, congenital
hypertension, pulmonary
atrial fibrillation
