Evaluation Of Lung Function In Children With Left-to-right Shunt Congenital Heart Disease

Objective:To investigate the characteristics and influencing factors of pulmonary function parameters in children with left to right shunt congenital heart disease(congenital heart disease,CHD).Methods: 120 children with left to right shunt congenital heart disease who were hospitalized in the affiliated Hospital of Southwest Medical University and undergoing cardiac catheterization from May 2016 to December 2018 were selected as the CHD group.80 children with normal pulmonary function in the outpatient health examination of our hospital during the same period were selected as normal control group.(1)Children with CHD were divided into abnormal pulmonary function group(n = 60),normal pulmonary function group(n = 60)and normal control group(n =80).The basic clinical data,pulmonary function parameters and hemodynamic parameters were compared among the three groups.(2)The children with CHD were divided into pulmonary hypertension group(n =41),non-pulmonary hypertension group(n = 41),and normal control group(n = 80).The basic clinical data,pulmonary function parameters and hemodynamic parameters were compared among the three groups.(3)According to QP/QS,the children with congenital heart disease were divided into 4 groups.The hemodynamic parameters and pulmonary function parameters were compared among the four groups.(4)Thecorrelation between hemodynamic parameters(m PAP,QP/QS,PVR)and pulmonary function parameters was analyzed in children with congenital heart disease.Results:(1)The age of children with congenital heart disease in the abnormal pulmonary function group was slightly higher than that in the normal pulmonary function group and the normal control group,but there was no significant difference in height,weight and BMI among the three groups.The pulmonary hypertension group was slightly older than the normal control group,but the body weight was significantly lower than that of the normal control group.(2)From the normal control group,the normal pulmonary function group to the abnormal pulmonary function group,also from the normal control group and the non-pulmonary hypertension group to the pulmonary hypertension group,they all showed the level of pulmonary function parameter TPTEF,TPTEF/TE,VPTEF,VPEF/VE decreased while the level of PTEF,PTEF/VT increased gradually.The VT/kg was relatively low,RR was relatively fast,Te increased,and the level of Ti/Te was significantly lower than that of normal reference range in children with CHD.(3)The atrioventricular swptal defect or arterial duct diameter and QP/QS in abnormal pulmonary function group were larger than that in normal pulmonary function group.The atrioventricular swptal defect or arterial duct diameter,QP/QS,m PAP,PVR in pulmonary hypertension group were significantly larger than that in non-pulmonary hypertension group.According to QP/QS,compared the children with CHD in groups,when QP/QS increased,PVR relatively increased.PVR and m PAP were positively correlated with RR,PTEF/VT,while Te,TPTEF,VPTEF were negatively correlated with that.Conclusion:(1)The growth and development of children with left to right shunt CHD lags behind that of normal children of the same age..(2)Pulmonary function detection in children with left-right shunt CHD is mainly manifested as obstructive ventilation dysfunction,but also restrictive ventilation dysfunction and respiratory compensation.(3)Lung function test can reflect the characteristics of lung function and the severity of disease in children with CHD.