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本文研究用放射性核素显像评价小儿先天性心脏病伴肺动脉高压(PAH)的右心功能改变。NPH组(无PAH组)由于患儿均为左向右分流型,故QP/QS比值均显著增高,REDV明显高于NC组(正常对照组),1/3EF和PER也均升高,TPER缩短。MPH组(轻度PAH组)1/3FF和PFR明显低于NC组,TPFR明显延长,是先心伴PAH早期心功能损害的主要标志,说明右室心肌主动舒张特性的损害,右室收缩和舒张末压力均增高。SPH组(中重度PAH组)REDV和RESV均与NC组有明显差异,SPH组ESP/RESV明显低于NPH组。右心室的射血功能、RVEF等不仅受后负荷mPAP影响,而且受到前负荷、分流量、本身心肌收缩力的综合影响。提示本法为右心功能的无创性评价提供敏感、可靠依据。
This study was designed to evaluate radionuclide imaging in children with congenital heart disease with pulmonary hypertension (PAH) right heart function changes. The QP / QS ratio of NPH group (without PAH group) was significantly higher than that of NC group (normal control group), and the 1 / 3EF and PER also increased. TPER shorten. 1 / 3FF and PFR in MPH group (mild PAH group) were significantly lower than those in NC group and TPFR was prolonged significantly, which was the main marker of early cardiac dysfunction in PAH group, indicating the impairment of RV diastolic function and right ventricular contraction End diastolic pressure were increased. SPH group (moderate and severe PAH group) REDV and RESV were significantly different from the NC group, SPH group ESP / RESV was significantly lower than the NPH group. Right ventricular ejection function, RVEF and so on are not only affected by post-load mPAP, but also by the pre-load, sub-flow, its own combined effect of myocardial contractility. Tip This method provides a sensitive, reliable basis for noninvasive evaluation of right ventricular function.