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目的应用实时三维超声心动图(RT-3DE)评价法乐氏四联症(TOF)患儿右室整体及局部容积和收缩功能。方法 RT-3DE采集45例TOF患儿,平均年龄(1.37±2.91)岁及46例正常同龄匹配对照组,平均年龄(1.37±2.85)岁右室全容积声像图,应用TomTec RV-Function软件分析右室整体及局部容积和收缩功能,测量指标:舒张末期容积(EDV)、收缩末期容积(ESV)、射血分数(EF)、容积峰值收缩速率(PSVR)。结果右室整体、流入道、心尖小梁部EDV与正常对照组无显著差异(P>0.05),但上述各容积值为体表面积标化后均大于正常对照组(P<0.05),流出道EDV及标化后容积均较正常对照组减小(P<0.05);右室整体EF、PSVR及三局部EF均较正常对照组减低(P<0.05)。结论 TOF患儿右室流出道发育不良性狭窄导致右室流出道容积减小,而右室整体、流入道、心尖小梁部容积增大,并伴有右室收缩功能受损。
Objective To evaluate the global right ventricular volume and systolic function in children with Tetralogy of Fallot (TOF) by real-time three-dimensional echocardiography (RT-3DE). Methods Forty-five children with TOF were collected by RT-3DE. The mean age (1.37 ± 2.91) years old and 46 normal matched age matched controls (mean age 1.37 ± 2.85) The whole right ventricle and local volume and systolic function were analyzed. The indexes of measurement included end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF) and peak volume of systolic velocity (PSVR). Results There was no significant difference in EDV between right ventricle, inflow tract and apex trabeculae (P> 0.05), but the values of volume above were normalized to body surface area (P <0.05) EDV and normalized volume decreased compared with the normal control group (P <0.05). The total right ventricular EF, PSVR and three local EFs were lower than the normal control group (P <0.05). Conclusions The dysplasia of right ventricular outflow tract in TOF children leads to the decrease of right ventricular outflow tract volume, while the volume of the right ventricle as a whole, the inflow tract and the apex trabeculae increases, accompanied by impaired right ventricular systolic function.