摘要
目的:评价青少年特发性二尖瓣脱垂（MVP）的超声诊断价值及特点,探讨HLA与特发性MVP的相关性。方法:回顾性分析29例经手术及病理证实的特发性MVP伴有严重二尖瓣关闭不全的超声检查结果:用PCR-SSP方法检测29例福建籍特发性MVP患者HLA-DR的特异性抗原频率,并与65例本地区正常人相对照。结果:29例中有20例被二维超声正确诊断为特发性MVP,其中3例仅在心尖四心腔可见瓣膜脱垂,超声显像示瓣叶冗长、不增厚、无粘连,瓣口面积大;另9例被超声误诊为风湿性病变,超声显像示二尖瓣均有不同程度增厚及粘连,舒张期二尖瓣开放稍呈穹隆样;但均无钙化,且合并有严重的二尖瓣关闭不全。特发性MVP的HLA-DR15抗原频率明显增高,有显著差异（P<0.05）。结论:青少年患者瓣膜脱垂伴有严重关闭不全而无明显瓣膜粘连、增厚及狭窄者均应考虑患有本病。此外特发性MVP的发病与HLA-DR15的异常表达有关。
Objective: In order to evaluate the value of two-dimensional echocardiography (2D) in diagnosing the primary mitral valve prolapse (MVP); explore the correlation between human leukocyte antigen (HLA) and primary MVP. Methods: Data of 29 patients with MVP confirmed by surgery and pathology were retrospectively analyzed ; special antigen frequency of site of HLA-DR in 29 Fujian patients with MVP was detected by PCR-SSP technology. Results: Twenty of twenty-nine patients with MVP associated with severe mitral regurgitation were diagnosed as primary MVP by 2D, but 3 patients were presented only in apical four chamber views; nine patients with MVP were misdiagnosed as rheumatic valvular disease by 2D, because of the mild leaflet thickening, subvalvular changes. There was positive correlation between primary MVP and HLA-DR 15, there was incremental tendency of antigen frequency of HLA-DR 15 (P<0. 05) .Conclusion: The mitral valve prolapse associated with severe mitral regurgitation without severe mitral thickening and narrowness in younger patients should be considered as primary MVP; moreover there is correlation between primary MVP and abnormal expression of HLA-DR 15.
出处
《心血管康复医学杂志》
CAS
2002年第4期320-323,共4页
Chinese Journal of Cardiovascular Rehabilitation Medicine
