| 摘要: |
| 目的 探讨超声心动图测量的标准化肺动脉指数在预测法洛四联症(TOF)根治术患者预后中的临床应用价值。方法 纳入2003年至2020年于我院行TOF根治术患者465例。利用术前超声心动图测量参数计算肺动脉瓣环Z值(PVAZ)、肺动脉主干Z值(MPAZ)及Nakata指数,随访术后结局。利用PVAZ预测术中是否行跨瓣环补片(TAP),分析各指数与围术期临床指标的相关性,采用ROC曲线分析确定各指数的最佳截断值并进行生存分析。结果 TOF根治术中共413例(88.8%)行TAP。ROC曲线分析显示,行TAP患者PVAZ=-2.725时,曲线下面积(AUC)=0.740,敏感性0.528,特异性0.860。MPAZ和Nakata指数与围术期临床指标的相关性较好,MPAZ和Nakata指数越低提示更长的体外循环时间和术后护理时间。中位随访时间为2.03年,随访期间共发生23例死亡(4.95%)。ROC曲线分析确定PVAZ=-3和MPAZ=-3.5为预测患者生存的最佳截止值,组间患者生存差异均具有统计学意义。结论 基于超声心动图测量的标准化肺动脉指数是评价TOF根治术患者预后的良好预测指标,对临床危险分层具有一定的指导意义。 |
| 关键词: 法洛四联症 超声心动图 肺动脉指数 Z值 |
| DOI： |
| 投稿时间：2020-11-20修订日期：2020-11-20 |
| 基金项目:陆军军医大学第二附属医院军事临床医学创新技术项目(2018JSLC0032)；重庆市社会事业与民生保障科技创新专项重点研发项目(cstc-2017shms-zdyfX0017) |
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| Application of standardized pulmonary indexes based on echocardiography to predict the prognosis of repaired tetralogy of Fallot |
| Lai Xiaoyue,Jiang Huan,Deng Xi,Xia Hongmei |
| () |
| Abstract: |
| Objective To explore the value of standardized pulmonary indexes based on echocardiography in the prediction of the prognosis of repaired tetralogy of Fallot (TOF). Methods 465 TOF patients who underwent complete repair from 2003 to 2020 in our hospital were included, pulmonary valve annulus Z-score (PVAZ), main pulmonary artery Z-score (MPAZ) and Nakata index were calculated based on echocardiographic evaluation. The postoperative outcomes were followed up. Receiver operating characteristic (ROC) curve was used to predict the practice of transannular patch (TAP). Correlation analysis was performed between the pulmonary indexes and clinical data during perioperative management. ROV curve was again used to confirm best cut-off values and conduct survival analysis. Results A total of 413 cases (88.8%) underwent TAP during complete repair. For the practice of TAP, when PVAZ=-2.725, area under the curve (AUC)=0.740, sensibility=0.528, specificity=0.860. MPAZ and Nakata index turned out to be well-related to the perioperative results, with lower MPAZ and Nakata index indicating longer time of operation and postoperative care. There were 23 cases (4.95%) of death during a median follow-up time of 2.03 years. PVAZ=-3 and MPAZ=-3.5 were confirmed as the cut-off values and the survival differences between the groups were statistically significant. Conclusion Standardized pulmonary indexes based on echocardiographic evaluation are good indicators to predict the prognosis of repaired TOF, which may be of great guiding significance in the clinical hazard stratification. |
| Key words: Tetralogy of Fallot Echocardiography pulmonary index Z-score |
