摘要
目的探讨超声心动图诊断冠状动脉瘘(CAF)的临床价值,观察不同类型CAF对心功能的影响。方法回顾性分析91例CAF患者与30名健康人(对照组)的超声心动图数据,根据漏入心腔位置,将CAF患者分为冠状动脉-肺动脉瘘型(Ⅰ型)、冠状动脉-右心房瘘型(Ⅱ型)、冠状动脉-右心室瘘型(Ⅲ型)、冠状动脉-左心室瘘型(Ⅳ型)4组。将4组患者的心功能分别与对照组进行比较,并分析4组心功能的组间差异。按照心脏有无继发改变,将CAF患者分为2组,比较2组分流量及心功能。结果与对照组相比,Ⅰ型和Ⅱ型CAF患者的左心室射血分数(EF)、短轴缩短率差异均有统计学意义(P均<0.05),左心室舒张末期容积及收缩末期容积、每搏输出量(SV)、右心室横径(RVTD)差异均无统计学意义(P均>0.05);Ⅲ型CAF患者各项心功能指标差异均无统计学意义(P均>0.05);Ⅳ型CAF患者各项心功能指标差异均有统计学意义(P均<0.05);4组CAF患者之间,除RVTD外,各项指标差异均有统计学意义(P均<0.05)。心脏有无继发改变CAF患者间分流量的差异、心功能EF、SV的差异均有统计学意义(P<0.05)。结论不同类型CAF对心功能的影响可不同,冠状动脉-左心室瘘型CAF对心功能的影响最为显著,但EF尚在正常范围内;CAF对血流动力学的影响与分流束学习漏入的位置、分流量有关。
Objective To investigate the value of echocardiography in diagnosing coronary artery fistula （CAF） and the influence of different types of CAF on cardiac function. Methods Echocardiographic data of 91 patients with CAF and 30 healthy subjects （control group） were retrospectively reviewed. The patients were divided into 4 types according to position of fistula （4 groups） ： Coronary-pulmonary fistula （type I ）, coronary-right atrium fistula （type II ）, coronary-right ventricle fistula （type III ） and coronary-left ventricle fistula （type IV）. The cardiac function among 4 patients groups and control group were compared, and intergroup differences of 4 types were analyzed. In addition, the patients were divided into two groups according to with or without complications, and the split-flow and cardiac function were compared. Results In types I and II , significant differences of ejection fraction （EF） and fractional shortening were observed compared with control group （P〈0.05）, but not in left ventricular end diastolic volume, end systolic volume, stroke volume （SV） nor right ventricular transection diameter （all P〉0.05）. There was no obvious difference in cardiac function of type III （all P〈0.05）, but there was difference in that of type IV （all P〈0.05）. The results of intergroup difference of 4 types of CAF stated that there were statistical differences of the above indexes among 4 types except RVTD （all P〈0.05）. In addition, significant differences were observed between patients with complications or without complications in split-flow, EF and SV in cardiac function （all P〈0.05）. Conclusion The type of CAF can influence cardiac function. Coronary-left ventricle fistula has the most obvious impact on cardiac function, while EF may still normal. Hemodynamic changes correlates with the position and shunt flow of CAF,
出处
《中国医学影像技术》
CSCD
北大核心
2013年第6期919-922,共4页
Chinese Journal of Medical Imaging Technology
基金
陕西省课题基金(2011K12-22)
