国产C-L短柱侧倾碟瓣置换术后远期跨瓣压差的评价  

Assessment of Long-Term Transvalvular Gradients of A Domestic C-L Pugesturt Tilting Disc Mechanical Valve Prosthesis

作　　者：张亚文[1] 金海[2] 吴宗贵[1] 牛晓萍[3] 陈琴珍[1] 徐志云[2] 

机构地区：[1]上海长征医院心内科,上海市200003 [2]上海长海医院胸心外科 [3]上海长征医院超声科,上海市200003

出　　处：《中国循环杂志》2006年第6期438-440,共3页Chinese Circulation Journal

摘　　要：目的:评价国产C-L短柱侧倾碟瓣置换术后远期的跨瓣压差。方法:选择20例单纯置换C-L短柱侧倾碟瓣术后10年以上的患者,均为主动脉瓣置换,型号为21 mm,采用彩色多普勒超声心动图记录患者平板运动试验前、后的跨瓣压差。结果:在安静状态下、运动第Ⅱ阶段后及运动第Ⅳ阶段后,最大跨瓣压差分别为(12.66±3.12)mmHg、(15.70±4.20)nnnHg和(22.48±6.45)mmHg(1 mmHg=0.133 kPa),平均跨瓣压差分别为(7.25±2.42)mmHg、(8.71±3.11) mmHg和(14.66±4.23)mmHg。统计学检验结果显示:安静状态下、运动第Ⅱ阶段后、运动第Ⅳ阶段后相比患者的心率、血压有显著差别(P＜0.05);运动第Ⅱ阶段后患者的跨瓣压差无明显升高,与安静状态相比无显著差别(P＞0.05);运动第Ⅳ阶段后患者的跨瓣压差明显升高,与安静状态相比有显著差别(P＜0.05)。结论:轻度体力活动对国产C-L短柱侧倾碟瓣置换术后远期跨瓣压差没有明显影响,但中度体力活动会引起跨瓣压差升高。Objective： To assess the long-term transvalvular gradients of a domestic C-L pugesturt tilting disc （21 mm） mechanical valve prosthesis. Methods： Twenty patients undergoing domestic C-L pugesturt aortic valve replacement for at least 10 years were selected. Peak and mean transvalvular gradients were measured by Doppler echocardiography before and after exercise treadmill testing. Results： The peak transvalvular gradients at rest and the end of Ⅱ, Ⅳ stage exercise were （ 12. 6±6 3.12 ） mmHg, （ 15.70 ±4. 20） mmHg and （ 22.48±6.45 ） mmHg. The mean transvalvular gradients were （7.25±2.42 ） mmHg, （ 8. 71±3.11 ） mmHg and（ 14. 66 ± 4. 23 ） mmHg. There was a significant difference in heart rate and blood pressure at rest versus after exercise （P 〈 0.05 ）. There was no significant difference in transvalvular gradient at rest versus at the end of Ⅱ stage exercise （P 〉 0. 05 ）. There was a significant difference in transvalvular gradient at rest versus at the end of IV stage exercise （P〈0. 05 ）. Conclusion： Gentle physical activity does not induce significant increase of transvalvular gradients. But moderate physical activity will induce an increase of the transvalvular gradients of C-L pugesturt heart valve prosthesis.

关 键 词：心脏瓣膜 跨瓣压差 运动试验 

分 类 号：R654.2[医药卫生—外科学]