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目的利用经胸超声心动图探讨肺动脉顺应性指数(pulmonary arterial compliance index,PACI)评价行室间隔缺损(ventricular septal defect,VSD)封堵术患者肺动脉顺应性的价值,分析PACI与患者年龄及术后肺动脉收缩压(pulmonary arterial systolic pressure,PASP)变化的相关性。方法选取适合介入封堵治疗的膜周部VSD患者74例,根据年龄分为>40岁组、20～40岁组与<20岁组,根据术后PASP值分为>40 mm Hg组、30～40 mm Hg组与<30mm Hg组,74例患者术前均采用超声心动图测量缺损直径、跨缺损分流压差与PASP,计算VSD面积指数与PACI,术后3个月再次测量PASP,并进行分析及对比。结果 >40岁组术前PACI明显低于20～40岁组与<20岁组,术后PASP高于20～40岁组与<20岁组,差异有统计学意义(P<0.05),3组VSD面积指数比较差异无统计学意义(P>0.05);术后PASP>40 mm Hg组PACI低于30～40 mm Hg组与<30 mm Hg组,VSD面积指数高于30～40mm Hg组与<30mm Hg组,差异有统计学意义(P<0.05)。结论 VSD患者术后PASP的恢复与年龄及PACI相关,PACI可作为评价行VSD封堵术患者PASP恢复程度的指标之一。
Objective To evaluate the value of pulmonary arterial compliance index (PACI) in assessment of pulmonary artery compliance in patients undergoing ventricular septal defect (VSD) closure by transthoracic echocardiography. To analyze the relationship between PACI and age and postoperative Correlation of changes of pulmonary arterial systolic pressure (PASP). Methods Seventy-four patients with perimembranous ventricular occlusion (VSD) were enrolled in this study. They were divided into four groups according to their ages:> 40 years old, 20-40 years old and <20 years old. According to PASP, they were divided into 40 mm Hg group, 30 ~ 40 mm Hg group and <30 mm Hg group. 74 patients underwent echocardiography before surgery to measure the diameter of the defect, differential pressure across the defect and PASP, calculate the VSD area index and PACI, and measure PASP again 3 months after the operation For analysis and comparison. Results The preoperative PACI in the 40-year-old group was significantly lower than that in the 20-40-year-old group and the <20-year-old group. The postoperative PASP was higher in the 20-40 years old group and <20 years old group, with significant difference (P <0.05) There was no significant difference in the area index of VSD between groups (P> 0.05). The PACI of PASP> 40 mm Hg group was lower than 30 ~ 40 mm Hg group and <30 mm Hg group, the VSD area index was higher than that of 30 ~ 40 mm Hg group And <30mm Hg group, the difference was statistically significant (P <0.05). Conclusion The postoperative recovery of PASP in patients with VSD is related to the age and PACI. PACI can be used as an index to evaluate the recovery of PASP in patients with VSD.