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目的 :研究认为 ,用超声心动图方法可以准确估测Ⅱ孔型房间隔缺损 (ASD)的伸张径 ,其直线回归方程为 :ASD伸张径估测值 =1 0 5×超声测量值 (mm) +5 4 9。本研究即验证该公式评估ASD伸张径的准确性。方法 :选择 2 0 0 0年 4月至 2 0 0 0年 11月澳大利亚墨尔本皇家儿童医院接受介入封堵治疗的单纯性Ⅱ孔型ASD 2 0例。所有患者在封堵治疗前常规行右心导管检查 ,用球囊测得ASD伸张径 ,作为金标准。导管检查前行二维经胸超声心动图检查 ,取剑下四腔心长轴和短轴切面下ASD直径的平均测量值 ,计算出ASD伸张径的超声估测值。比较超声估测值和球囊测量值 ,行相关与回归分析 ,计算回归系数。所有数据均经正态性检验 ,组间变量行配对t检验。结果 :由超声测量值 (9 8± 2 9)mm计算出的伸张径估测值 (15 8± 3 2 )mm与球囊测量值 (15 5± 4 0 )mm之间有良好相关 (r =0 9,P <0 0 0 1,S x=2 4 ) ,组间差异无统计学意义。结论 :用超声心动图方法估测ASD伸张径可作为封堵治疗病例选择和Amplatzer型号选择的临床标准。
PURPOSE: The study suggests that the echocardiographic method can be used to accurately estimate the diameter of atrial septal defect (ASD) in type II. The linear regression equation is as follows: Estimated value of ASD diameter = 105 mm Ultrasound measurement (mm) +5 4 9. This study verifies the accuracy of this equation for assessing the ASD stretch. Methods: From April 2000 to November 2000, 20 children with simple type II ASD admitted to the Royal Melbourne Children’s Hospital in Melbourne, Australia were enrolled. All patients underwent conventional right heart catheterization prior to occlusion therapy and ASD diameter as measured by balloon as the gold standard. Two-dimensional transthoracic echocardiography was performed before catheterization. The average ASD diameter under long-axis and short-axis views of the four-chamber under the sword was measured to calculate the estimated ultrasound ASD diameter. Comparison of ultrasound and balloon measurements, line correlation and regression analysis, calculation of regression coefficients. All data were tested by normality, and the variables between groups were paired t test. RESULTS: The estimated radii of elongation (15 8 ± 3 2) mm calculated from the ultrasound measurements (9 8 ± 29) mm were in good agreement with the balloon measurements (15 5 ± 40) mm (r = 0 9, P <0 0 0 1, S x = 2 4). There was no significant difference between the two groups. CONCLUSIONS: Estimating ASD diameter using echocardiography can be used as a clinical standard for choice of closure and selection of Amplatzer models.