Abstract：【Objective】To investigate the diagnostic value of superior vena cava (SVC) blood flow spectrum parameters in children with pulmonary hypertension (PAH).【Methods】From September 2019 to May 2022, 49 patients with PAH diagnosed by cardiac catheterization in our hospital (PAH group) were selected; In addition, 15 healthy children (control group) who were examined in our hospital at the same time were selected. All subjects were examined by transthoracic echocardiography, collected the SVC blood flow spectrum curve, and evaluated the diagnostic value of SVC blood flow spectrum parameters for PAH using the subject's work characteristic (ROC) curve. 【Results】 The SVC spectrum of the control group showed four phase wave [Systolic concentric wave (S wave), diastolic concentric wave (D wave), late systolic centrifugal wave (VR wave), and atrial late systolic centrifugal wave (AR wave)]; In the PAH group, 44 patients had four phase waves and 5 patients had non four phase waves. The peak velocity of AR wave, the peak velocity of VR wave, and AR/S in the PAH group were significantly higher than those in the control group (P<0.05). The peak velocity of S wave, the peak velocity of D wave, and AR/D, VR/S, VR/D in the two groups had no significant difference (P>0.05). The ROC curve analysis showed that the area under the AR/S curve was 0.812, which was the best for the diagnosis of PAH; When AR/S cut-off value was 0.43, the sensitivity of PAH diagnosis was 68.00%, and the sensitivity of moderate and severe PAH diagnosis was 74.00%. 【Conclusion】 The changes of SVC blood flow spectrum can reflect the changes of PAH. Among them, AR/S has certain diagnostic value for PAH, especially for moderate and severe PAH. When tricuspid regurgitation is not obvious or more ultrasonic support is needed, AR/S can become an effective reference index for clinical diagnosis of PAH in children.
姚桃月, 刘倩君, 胡原, 周梦洁, 李文凤, 刘金桥. 上腔静脉血流频谱参数对儿童肺动脉高压的诊断价值[J]. 医学临床研究, 2022, 39(9): 1299-1302.
YAO Tao-yue, LIU Qian-jun, HU Yuan, et al. Diagnostic Value of Superior Vena Cava Blood Flow Spectrum Parameters in Children with Pulmonary Hypertension. JOURNAL OF CLINICAL RESEARCH, 2022, 39(9): 1299-1302.
[1] HOCKSTEIN M A,HAYCOCK K,WIEPKING M.Transthoracic right heart echocardiography for the intensivist[J].J Intensive Care Med,2021,36(9):1098-1109.
[2] 李晓娣,张缪佳.抗SSA/Ro52抗体参与结缔组织疾病相关肺动脉高压发发展的机制[J].医学临床研究,2019,36(1):106-107.
[3] 艾月琴,路东明.AECOPD患者并发肺动脉高压的危险因素分析[J].医学临床研究,2018,35(9):1755-1757.
[4] POCH D,MANDEL J.Pulmonary hypertension[J].Ann Intern Med,2021,174(4):ITC49-ITC64.
[5] 中华医学会呼吸病学分会肺栓塞与肺血管病学组,中国医师协会呼吸医师分会肺栓塞与肺血管病工作委员会,全国肺栓塞与肺血管病防治协作组,等.中国肺动脉高压诊断与治疗指南(2021版)[J].中华医学杂志,2021,101(1):11-51.
[6] 孙丹丹,侯颖,尚福军,等.上腔静脉频谱指标评价肺动脉高压的应用[J].中华超声影像学杂志,2016,25(6):466-469.
[7] HOU Y,SUN D D,YUAN L J.Clinical application of superior vena cava spectra in evaluation of pulmonary hypertension:a comparative echocardiography and catheterization study[J].Ultrasound Med Biol,2016,42(1):110-117.
[8] 侯颖,袁丽君,王跃民.上腔静脉频谱对大鼠肺动脉高压的评价作用[J].中华医学超声杂志(电子版),2016,13(2):154-160.
[9] 孙丹丹,段云友,侯颖.肝中静脉血流频谱变化对肺动脉高压诊断的临床评价[J].中国超声医学杂志,2015,31(4):336-339.
[10] MARCUS J T,WESTERHOF B E,GROENEVELDT J A,et al.Vena cava backflow and right ventricular stiffness in pulmonary arterial hypertension[J].Eur Respir J,2019,54(4):1900625.
2022, Vol. 39 
