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目的超声心动图评价动脉导管未闭(PDA)合并中、重度肺动脉高压(PH)患者封堵术后心脏形态结构和肺动脉压的变化。方法将28例成功实施PDA封堵术患者分为中度PH组(A组)和重度PH组(B组)。B组分为左室增大组(B1组)和左室大小正常组(B2组)。术前、术后24h、5d、1、3、6、12个月行超声心动图检查,测量心脏各房室大小及肺动脉收缩压(SPAP)。结果 (1)封堵术后12个月A组肺动脉压SPAP下降最快。B1组肺动脉压缓慢下降,B2组下降程度小于B1组。(2)A组、B1组术前左心增大,术后逐渐缩小,A组左心形态逆转更为明显。B1组、B2组术前右心增大,术后均不同程度回缩。结论 PDA封堵术后肺动脉压不同程度降低,心脏形态重构明显。
Objective To evaluate the changes of cardiac morphology and pulmonary artery pressure after occlusion of patent ductus arteriosus (PDA) with moderate and severe pulmonary hypertension (PH) in patients with patent ductus arteriosus (PDA). Methods Totally 28 patients who underwent successful PDA occlusion were divided into moderate PH group (group A) and severe PH group (group B). Group B included left ventricular enlargement (group B1) and left ventricular normal (group B2). Echocardiography was performed preoperatively, 24h, 5d, 1, 3, 6 and 12 months after surgery to measure the heart size and pulmonary artery systolic pressure (SPAP). Results (1) The pulmonary arterial pressure (SPAP) in group A decreased most rapidly at 12 months after closure. The pulmonary arterial pressure in group B1 decreased slowly, and that in group B2 decreased less than that in group B1. (2) Left ventricular diameter increased in group A and group B1, and gradually decreased after operation. The left ventricular morphology reversed more obviously in group A. B1 group, B2 group preoperative right heart increased, postoperative were varying degrees of contraction. Conclusions After PDA occlusion, the pulmonary arterial pressure is reduced to different degrees and the cardiac morphology is obviously remodeled.