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目的 分析房间隔缺损 (ASD)直径的经胸超声心动图 (TTE)测量值、经食管超声心动图(TEE)测量值、左房造影测量值及肺循环血量 体循环血量比值 (QP QS)与球囊导管测量的ASD直径的关系 ,评价ASD直径的各种测量方法在介入治疗中的应用价值。方法 全组共 40例 ,均于心导管检查前 1周内接受TTE及TEE检查 ,以测量到的ASD直径的最大值作为该ASD直径的TTE及TEE测量值。右心导管检查中以Fick法计算QP QS。 14例患者行左房造影测量ASD直径。 40例均于心导管术中以球囊导管测量ASD直径并以此作为ASD直径的球囊测量值。结果 ASD直径的TTE、TEE及造影测量值均明显小于球囊测量值 (P <0 0 0 1) ,但TTE、TEE的测量值与球囊测量值显著相关 ,(r=0 85 8、0 834,P <0 0 0 1) ,且TTE测量值与球囊测量值的相关性较TEE更高 ,而左房造影测量值与球囊测量值无统计学相关 (P =0 2 14)。QP QS与球囊测量值亦存在统计学相关 (r=0 373)。ASD的TTE和TEE测量值之间无统计学差异 (P =0 2 0 ) ,但有良好的相关性 (r =0 771,P <0 0 0 1)。结论 ASD直径的球囊测量值仍应作为选择封堵器的“金标准” ,应用TTE可较准确的独立估测ASD直径的球囊测量值 ,可用于介入治疗的患者。TEE对球囊测量值的估测并不优于TTE ,但可提供更多的?
Objective To analyze transthoracic echocardiography (TTE), transesophageal echocardiography (TEE), left atrium angiography and pulmonary circulation blood volume QP QS for ASD diameters and Balloon catheter ASD diameter measurement of the relationship between the ASD diameter evaluation of various measurement methods in interventional therapy value. Methods A total of 40 patients were enrolled in this study. All patients underwent TTE and TEE within 1 week prior to cardiac catheterization. The maximum measured ASD diameter was used as the TTE and TEE measurements for this ASD diameter. QP QS was calculated by Fick method in right heart catheterization. 14 patients underwent left atrial angiography measurement of ASD diameter. All 40 patients underwent endocardial catheterization with a balloon catheter to measure the ASD diameter and use this as a balloon measurement of ASD diameter. Results The TTE, TEE and contrast measurements of ASD were significantly smaller than those of the balloon (P <0.01), but the TTE and TEE measurements were significantly correlated with balloon measurements (r = 0 85 8,0 834, P <0 0 0 1), and the correlation between TTE measurements and balloon measurements was higher than that of TEE, whereas there was no significant correlation between left atrial measurements and balloon measurements (P = 0 2 14). There was also a statistically significant correlation between QP QS and balloon measurements (r = 0 373). There was no significant difference between TTE and TEE measurements in ASD (P = 0 2 0), but there was a good correlation (r = 0 771, P 0 01). Conclusions The balloon diameter of ASD should still be used as the “gold standard” for the selection of occluders. TTE can be used to estimate the ASD balloon diameter more accurately and accurately and can be used for interventional therapy. TEE estimates of balloon measurements are not superior to TTE but provide more?