摘要
目的评价经皮球囊二尖瓣成形术（percutaneous balloon mitral valvuloplasty,PBMV）的中远期疗效、再狭窄率及影响因素。方法我院1996年1月至2001年6月资料完整的83例PBMV中,男性12例（14.46%）,女性71例（85.54%）,年龄20-68岁,平均41.56±10.68岁。随访5-10年,平均3.1±2.4年。收集术前、术后2天以及5-10年超声心动图和临床评估资料进行回顾性分析。结果PBMV术后二尖瓣口面积（MVA）由术前1.05±0.23cm^2增大为1.98±0.27cm^2（P〈0.01）,95.18%患者心功能改善1级以上。在5-10年随访中,81.93%患者心功能维持在Ⅰ-Ⅱ级,生存率98.8%,MVA面积逐步缩小为1.69±0.27cm^2,再狭窄率为31.33%。多重逐步回归分析示心房颤动心律（偏回归系数1.2140,P=0.0015）、术前心功能（偏回归系数1.2234,P=0.0008）、Wilkins评分（偏回归系数1.2187,P=0.0056）与术后和随访中MVA大小和心功能的维持有显著相关关系。结论PBMV术后可保持良好的中远期疗效,术前窦性心律、Wilkins评分≤8分、心功能良好的患者远期疗效最佳。
Objective To report the 5 - 10 years clinical follow-up results of patients who underwent percutaneous balloon mitral valvuloplasty （PBMV） in order to verify the interim and long term results, as well as the incidence and risk factors of restenosis. Methods From January 1996 to June 2001, 83 patients including 12 males and 71 females, with age of 20 - 68 years old （ mean age of 41.56 ± 10.68 years old）. The clinical data and echocardiography before and 2 days after PBMV, and 5 - 10 years （mean 3. 1 ± 2. 4 years） follow up were studied retrospectively by the SPSS software. Results The mitral valve area （MVA） increased from 1.05 ±50. 23 cm^2 before PBMV to 1.98 ±0. 27 cm^2 2 days after PBMV （P〈 0. 01 ）, and 95.18% of patients showed at least one class improvement in cardiac function （ NYHA class）. During 5 - 10 years follow up, the survival rate was 98. 8%, and 81.93% of patients remained in NYHA class Ⅰ or Ⅱ, but the MVA decreased to 1.69 ± 0.27 cm^2 with a restenosis rate of 31.33%. Through multiple stepwise regression analysis, the maintenance of MVA and cardiac function after PBV was shown to be correlated with the presence of atrial fibrillation （partial regression coefficient = 1. 214 0, P = 0. 001 5 ）, pre - operation cardiac function （ partial regression coefficient = 1. 223 4, P = 0. 000 8 ） and the Wilkins score （ partial regression coefficient = 1.218 7, P = 0. 005 6）. Conclusion PBMV can maintain a satisfying interim and long term clinical results. Patients with pre -operational sinus rhythm and Wilkins score≤8, as well as in the absence of heart failure may achieve better outcomes.
出处
《中国介入心脏病学杂志》
2007年第2期84-86,共3页
Chinese Journal of Interventional Cardiology
