付 君,张永刚,王 征,宋 凯,刘 超,郑国权,张国莹,崔 赓,张雪松,王 岩.强直性脊柱炎后凸畸形患者经椎弓根椎体截骨术后心功能变化[J].中国脊柱脊髓杂志,2016,(1):43-47. |
强直性脊柱炎后凸畸形患者经椎弓根椎体截骨术后心功能变化 |
中文关键词: 强直性脊柱炎后凸畸形 心功能 静息心率 经椎弓根椎体截骨术 |
中文摘要: |
【摘要】 目的:观察强直性脊柱炎(ankylosing spondylitis,AS)后凸畸形患者应用经椎弓根椎体截骨术(pedicle subtraction osteotomy,PSO)治疗后心功能的变化。方法:2011年10月~2013年10月共有36例行PSO的AS患者纳入本研究,男31例,女5例;年龄21~50岁(39±10岁);病程5~27年(17±6年),术前后凸Cobb角45.5°~108.8°(63.8°±22.4°)。术前和术后1年时评测患者静息心率、活动能力评分(active capacity score,ACS),并行超声心动图检查,测量指标包括左心室射血分数(left ventricular ejection fraction,LVEF)、左心室缩短分数(left ventricular fraction shortening,LVFS)、左心室舒张早期血流峰值速度(E峰)、舒张中晚期血流峰值速度(A峰)、E/A比值、E峰减速时间(deceleration time,DT)、等容舒张时间(isovolumetric relaxation time,IVRT),根据美国和欧洲超声学会指南评估患者左心室舒张功能。结果:随访至术后1年,共有32例完成了随访,失访率为11.1%。术后后凸Cobb角5.1°~34.5°(18.1°±10.9°),矫正率43.8%~94.4%[(74.8±15)%]。术前静息心率为85.9±12.5次/min,术后1年随访时降低至71.8±9.7次/min(P=0.0000);术前ACS为47.4±18.2分,术后1年随访时增加至78.3±12.6分(P=0.0000)。术前14例患者左心室舒张功能正常,术后1年随访时25例患者左心室舒张功能正常,其中2例术前左心室舒张功能正常的患者术后1年随访时为左心室舒张功能轻度障碍,临床改善率为72.2%(13/18)。E/A比值术前为1.02±0.36,术后1年随访时增加至1.24±0.27(P=0.0075),术后1年随访时DT由术前234.84±32.46ms缩短至211.56±26.74ms(P=0.0027),术前IVRT为102.50±19.86ms,术后1年随访时减少至87.92±13.12ms(P=0.0010)。术前和术后1年随访时LVEF和LVFS均正常,且无统计学差异(P>0.05)。结论:AS后凸畸形患者PSO术后1年随访时心功能较术前有改善。 |
Cardiac function changes in patients with ankylosing spondylitis kyphosis after pedicle subtraction osteotomy |
英文关键词:Ankylosing spondylitis kyphosis Cardiac function Resting heart rate Pedicle subtraction osteotomy |
英文摘要: |
【Abstract】 Objectives: To observe the postoperative changes in cardiac function of patients with ankylosing spondylitis(AS) kyphosis after the pedicle subtraction osteotomy(PSO). Methods: The original cohort consisted of 36 patients(31 males and 5 females) treated in our hospital from October 2011 to October 2013. The age was 21 to 50 years(39±10 years) and the duration of AS was 5 to 27 years(17±6 years). Echocardiographic measurements, resting heart rate(RHR), active capacity score(ACS), and full-length spine X-ray films in natural standing position were obtained before surgery and at 1-year follow-up. Echocardiographic parameters were measured as follows: left ventricular ejection fraction(LVEF) and left ventricular fraction shortening(LVFS), mitral early diastolic velocity(E), late diastolic velocity(A), E/A ratio, E deceleration time(DT) and isovolumetric relaxation time(IVRT). And the left ventricular(LV) diastolic function was assessed by the recommendations of American and European Society of Echocardiography. Results: 32 patients(28 males and 4 females) completed the follow-up and 4(3 males and 1 female) patients lost. The preoperative RHR was 85.9±12.5 beats per minute, whereas it was reduced to 71.8±9.7 beats per minute at 1-year follow-up(P=0.0000). The ACS was improved from 47.4±18.2 points preoperatively to 78.3±12.6 points at 1-year follow-up(P=0.0000). 14 patients(2 patients were turned into mild LV diastolic dysfunction at 1-year follow-up) had normal LV diastolic function before operation while there were 25 patients at 1-year follow-up. The clinical improvement rate was 72.2%(13/18). The preoperative DT was 234.84±32.46ms, and it was reduced to 211.56±26.74ms at 1-year follow-up(P=0.0027). The IVRT before PSO was 102.50±19.86ms, while it decreased to 87.92±13.12ms at 1-year follow-up(P=0.0010). The E/A ratio increased from 1.02±0.36 preoperatively to 1.24±0.27 at 1-year follow-up(P=0.0075). Conclusions: The postoperative cardiac function in patients with AS kyphosis is significantly improved at 1-year follow-up. |
投稿时间:2015-11-13 修订日期:2015-12-15 |
DOI: |
基金项目: |
|
摘要点击次数: 2674 |
全文下载次数: 1515 |
查看全文 查看/发表评论 下载PDF阅读器 |
关闭 |