摘要
目的了解核素肺灌注扫描检查在判断先天性心脏病合并肺动脉高压（ＰＨ）患者肺血管病变程度及其临床应用价值。方法以８１例左向右分流型先天性心脏病患者（ＣＨＤ）为受试对象，行９９ｍＴｃ－ＭＡＡ肺灌注显像检查（ＰＰＳ）。通过分析肺内核素总计数（ＬＲＣ）、右上下肺核素计数比（ＲＵＬＲ）、肾显影核素计数比（ＫＣＲ）等指标，与右心导管资料进行对比分析。结果发现ＰＰＳ各项指标与平均肺动脉压（ｍＰＡＰ）、全肺阻力（ＴＰＲ）有不同程度的相关性，ＫＣＲ、ＲＵＬＲ与ｍＰＡＰ相关系数（γ）分别为０．２５和０．３５；ＬＲＣ、ＫＣＲ与ＴＰＲ的相关性分别为－０．３４和０．２９。术后随诊５例，发现术后近期与术前比较，ＰＰＳ结果无明显变化。结论核素肺灌注显像检查可以通过定量分析方法来了解ＰＨ的病变程度。它做为一种无创性检查手段，以其简便、安全、可多次重复等优点，在ＣＨＤ合并ＰＨ的术前常规筛选、术后随诊等方面，皆有其明显的优点和实用价值。
Objective To evaluate the degree of pulmonary hypertension in patients with congenital heart disease (CHD) by using radionuclide pulmonary perfusion imaging. Method The pulmonary perfusion in 81 patients with left to right cardiac shunts was examined by scintigram with macroaggregates of 99m Tc labeled human serum albumin (PPS). PPS was analyzed for (1) lung regional radionuclide count (LRC), (2) right upper and lower lung count ratio (RULR), (3) kidney count ratio (KCR). The results were compared with those of cardiac cathterization exam. Result There were correlation between mean pulmonary arterial pressure (mPAP), total pulmonary resistance (TPR), and PPS (KCR、RULR with mPAP γ=0 25,0 35;LRC、KCR with TPR γ=-0 34,0 29).Five patients repeated PPS test after early operation.There were no changes in PPS. Conclusion The degree of reversibility of pulmonary hypertension in patients with CHD could be quantititively analysed by PPS.
出处
《中华外科杂志》
CAS
CSCD
北大核心
1998年第3期166-168,共3页
Chinese Journal of Surgery
关键词
先天性心脏病
肺动脉高压
放射性核素显像
Congenital heart disease Radionuclide imaging Pulmonary hypertension
