经胸二维超声心动图诊断不同部位二尖瓣脱垂的准确性  

Accuracy of Transthoracic Echocardiography for Detection of Mitral Valve Prolapse of Different Positions

作　　者：丛涛[1] 王珂[1] 

机构地区：[1]大连医科大学附属第一医院心内科,辽宁省大连市116011

出　　处：《中国循环杂志》2006年第6期453-456,共4页Chinese Circulation Journal

摘　　要：目的:评价经胸二维超声心动图诊断不同部位二尖瓣脱垂的准确性及其对术式选择的指导作用。方法:本研究共入选39例患者,均经二维超声心动图诊断为二尖瓣脱垂,并对其脱垂部位,脱垂程度,反流程度及各腔室大小进行了详尽的描述。该39例患者均行外科手术治疗,并将术中所见与超声心动图结果对照,首先根据术中所见瓣叶脱垂部位将患者分为前叶病变组(n=15),后叶病变组(n=19)及双叶病变组(n=5),比较各组间临床及超声心动图特点,明确超声心动图诊断不同部位二尖瓣脱垂的准确性。同时根据手术方式将患者分为瓣膜置换者(n=23)与瓣膜成形者(n=16),比较两类患者间的超声心动图特点。结果:39例患者中,超声心动图诊断与术中所见比较二尖瓣前叶病变组,后叶病变组及双叶病变组分别为14例及15例,22例及19例、3例及5例,诊断瓣叶脱垂伴腱索断裂者为17例及22例,与术中所见比较,该四者的准确率分别为92.3%,87.1%,89.7%及72%。在选择不同手术方式的比较的结果为,二尖瓣前叶及双叶脱垂者多行瓣膜置换术,二尖瓣后叶病变者多行瓣膜成形术。结论:二维超声心动图不仅能较准确地诊断不同部位的二尖瓣脱垂,同时对手术方式的选择具有重要的指导作用。Objective： To evaluate the accuracy of transthoracie eehocardiography for the detection of mitral valve prolapse at different positions and its guiding for a proper operation. Methods： Thirty nine patients were enrolled in this study. All the patients were diagnosed as having mitral valve prolapse by transthoracic echocardiography. The positions, the severity of mitral valve prolapse, and mitral regurgitation, and the magnitude of left ventricle or atrium were described. All the patients underwent operation. The echocardiographic results were compared with those obtained from the operations. Firstly,the patients were divided into three groups according to the different positions of mitral valve prolapse, anterior leaflet （ n = 15 ）, posterior leaflet （ n = 19） and both leaflets （ n = 5 ）. The echocardiographic and clinical characteristics were compared between groups, and the accuracy of transthoracic echocardiography for the detection of mitral valve prolapse at different positions were identified. Secondly, according to different operations, the patients were divided into two categories, One for valve repair and the other for valve replacement. The echocardiographic characteristics were compared. Results： Echocardiography identified 14 patients as having anterior leaflet prolapse, 22 having posterior leaflet prolapse, 3 having both kinds of leaflet prolapse and 17 having ruptured ehordae tendineae. Compared with operation, the diagnostic accuracy of transthoracic echocardiography was 92. 3%, 87.1%, 89. 7% or 72% ,respectively. Most patients with anterior leaflet or both kinds of leaflet prolapse underwent valve replacement and most patients with posterior leaflet prolapse underwent valve repair. Conclusion： Transthoracic echocardiography can accurately detect mitral valve prolapse at different positions. It is an important guide for choosing a proper operation.

关 键 词：超声心动描记术 二尖瓣脱垂 

分 类 号：R540.45[医药卫生—心血管疾病]