中老年继发孔型房间隔缺损治疗前后左房形态及功能的变化

李 伟; 张玉顺; 杜亚娟; 成革胜

中老年继发孔型房间隔缺损治疗前后左房形态及功能的变化

Effects of percutaneous closure of secundum atrial septal defect on size and function of left atrium in patients >40 years of age

摘要

摘要: 目的:分析成人继发孔型房间隔缺损（ASD）封堵术后左房形态及功能变化与年龄的关系。方法：49例成人ASD患者依据年龄分成二组:，<40岁组23（男13，女10）例，年龄20~38（31±12）岁。≥40岁组26（男9，女17）例，年龄40~72（49±14）岁。均于术前、术后2 d、1月、3月、6月行经胸超声心动图（TTE）检查，测量左房左右径及左房相关容积。结果：<40岁组ASD患者封堵术后3月，左房左右径较术前减小（P<0.05），≥40岁组ASD患者封堵术后6月左房左右径较术前减小（P<0.05）；<40岁组ASD患者封堵术后2 d左房储蓄容积较术前减小（P<0.05），≥40岁组ASD患者封堵术后6月较术前明显减小(P<0.05)；<40岁组ASD患者封堵术后3月左房被动排空容积较术前明显缩小（P<0.05），≥40岁组ASD患者封堵术后6个月时才明显缩小（P<0.01）；<40岁组ASD患者封堵术后1月，LAEF较术前明显增加（P<0.01）,≥40岁组ASD患者封堵术后3个月，LAEF较术前明显增加（P<0.01）。结论：≥40岁ASD患者封堵术后左房形态及功能恢复较慢。

Abstract: AIM:To analyze the influence of age on recovery of left atrial size and function after percutaneous closure of secundum atrial septal defect. METHODS: Forty-nine adult patients were divided into two groups: group A (23 patients), 13 males and 10 females aged from 20-38(31±12) years and group B (26 patients), 9 males and 17 females aged from 40-72(49±14) years. All patients had transthoracic echocardiogram (TTE) examination before as well as 2 days and 1, 3 and 6 months after operation to assess the diameter of left atrium and left atrial volume. RESULTS: Left atrium size in group A significantly decreased 3 months after operation compared with that before operation (P<0.05), whereas the size in group B decreased significantly 6 months after operation (P<0.05). LAVte in group A statistically reduced 2 days after operation (P<0.05), whereas in group B it did not decrease statistically until 6 months after operation (P<0.05). LAVpe reduced 3 months (P<0.05) and 6 months (P<0.01) after operation, whereas LAEF increased 1 month (P<0.01) and 3 months (P<0.01) after operation in respective group. CONCLUSION: Recovery of size and function of left atrium patients with ASD who were ≥40 years after percutaneous closure is slower compared with that in younger patients.

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