摘要
目的总结588例因二尖瓣关闭不全行瓣膜成形术患者的术前、术后1周及随访超声心动图表现,根据不同病因引起此种疾病的超声特点寻求最佳手术适应证。方法回顾性分析1989年至2008年因二尖瓣关闭不全行瓣膜成形术的患者588例。分析不同病因所致二尖瓣关闭不全患者具有的超声特点,以及超声在成形术前和术后对心脏血流动力学参数的评估。结果二尖瓣反流的病因有风湿性病变22例(3.7%),瓣膜退行性病变352例(59.9%),先天性二尖瓣病变134例(22.8%),感染性心内膜炎43例(7.3%),缺血性病变导致二尖瓣关闭不全28例(4.8%),肥厚型心肌病9例(1.5%)。左心房内径(LAD)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)较术前明显减低(P<0.05);术后1周测值和随访结果之间,LAD和LVEF差异有统计学意义(P<0.05),LVEDD与LVESD测值间差异无统计学意义。结论瓣膜退行性变是成年人二尖瓣关闭不全的最常见病因。超声心动图根据二尖瓣病变的形态特征和血流动力学参数可以对二尖瓣关闭不全的病因及病变程度作出明确诊断,帮助外科医师选择手术适应证,提高二尖瓣成形术成功率。
Objective To explore the indication of mitral valvuloplasty by analysing echocardiography phenotype in the 588 patients performed with mitral valvuloplasty for different diseases. Methods The echocardiography phenotype and dynamic parameters in the 588 patients performed with mitral valvuloplasty for improving mitral valve regurgitation （MR） were retrospectively analyzed.Results Five hundred and eighty-eight patients, including 349 male and 239 female subjects （ mean age of 39.83±19.48 years ） were enrolled. Twenty-two cases were rheumatic valve disease, 352 subjects with degenerative disease, 134 subjects with congenital mitral valve disease, 43 subjects with subacute bacteria] endocarditis, 28 subjects with ischemic MR, 9 subjects with myocardiopathy. All of LAD, LVEDD, LVESD, LVEF significantly decreased after mitral valvuloplasty. There was significant difference of LAD and LVEF between those after operation and follow-up respectively. However, no significant difference of LVEDD and LVESD was observed. Conclusion According to morphological characteristics and dynamic parameters, the pathological changes could be evaluated and the mitral valve disease was exactly diagnosed by echocardiography. Therefore the success rate of mitral valvuloplasty could be improved.
出处
《中华医学超声杂志（电子版）》
2010年第8期25-28,共4页
Chinese Journal of Medical Ultrasound(Electronic Edition)
