主动脉瓣周围管壁粥样硬化的超声观察及血流动力学分析  

Observation and Hymodynamic Analysis for Perivalvular Aortic Atherosclerosis on Echocardiography

作　　者：郭宝生[1] 任卫东[1] 唐力[1] 陈昕[1] 富维强[1] 喻晓娜[1] 李楠[1] 

机构地区：[1]中国医科大学附属第一医院心血管检查科,沈阳市110001

出　　处：《中国超声医学杂志》2008年第3期244-246,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的通过观察主动脉瓣周管壁动脉粥样硬化斑块发生位置来分析其形成的解剖学及力学基础。方法132例发生主动脉瓣周动脉粥样硬化斑快的患者作为研究对象,根据斑块与主动脉瓣的关系将其分为左冠瓣型、无冠瓣型及右冠瓣型,并分析各型间的发生率是否存在统计学差别。结果左冠瓣周的主动脉粥样硬化斑块发生率明显高于无冠瓣周(P<0.001)及右冠瓣周(P<0.001),且无冠瓣周高于右冠瓣周(P<0.001)。左冠瓣及无冠瓣周的动脉粥样硬化斑块常发生于近左、无冠瓣交界处瓣周的主动脉壁。结论左冠瓣周近主动脉左、无冠瓣交界处的主动脉壁易发生动脉粥样硬化斑块,与其位于具有一定弯曲度的左室流出道弯曲部外侧壁因而受到较大剪切力的作用有关。Objective To analyze the prerequisite in anatomy and mechanics for the formation of perivalvular aortic atherosclerotic （PVAA） plaques. The plaque location in PVAA on echocardiography was observed. Methods Totally 132 cases with aortic atherosclerotic plaques in PVAA were included in this study. According to the relationship of location between plaques and aortic valves, 3 types were divided：the left coronary leaflet, noncoronary leaflet and right coronary leaflet. The incidence of plaques on the 3 types were statistically analysed. Results The incidence of plaques near left coronary leaflet was significantly higher than that near non-coronary leaflet （P〈0. 001） and that near right coronary leaflet （P〈0. 001）, and near non-coronary leaflet was higher than that near right coronary leaflet （P〈0. 001）. Aortic atherosclerotic plaques of left coronary and non-coronary leaflets usually were present on the aortic wall near the junction of left coronary and non-coronary leaflets. Conclusions The PVAA of left coronary leaflet was the aortic wall plagues near the junction of left coronary. The non-coronary leaflet is susceptible to atherosclerosis ,because it related to the high wall shear stress of the outer wall in the left ventricular outflow tract.

关 键 词：主动脉粥样硬化 主动脉瓣周管壁 剪切力 血流动力学 

分 类 号：R543.1[医药卫生—心血管疾病]