超声心动图评价、预测二尖瓣修复术疗效  

Evaluating and Predicting the Outcomes of Mitral Valve Repair Using Echocardiogaphy

作　　者：黄国倩[1] 潘翠珍[1] 舒先红[1] 刘诗珍[1] 董丽莉[1] 陈灏珠[1] 

机构地区：[1]复旦大学附属中山医院心超室上海市心血管病研究所,上海200032

出　　处：《中国医学影像学杂志》2008年第3期181-184,共4页Chinese Journal of Medical Imaging

摘　　要：目的：运用超声心动图评价并预测二尖瓣修复术（mitral valve repair，MVR）疗效。材料和方法：2004-03～2006-06对120例MVR手术的患者行术前经胸超声心动图检查术后随访（随访时间1～25，5个月，平均6．1±5，4个月）。重点比较手术前、后二尖瓣反流（mitral regurgitation，MR）程度、左房前后径（LAD）、左室舒张末期内径（LVDd）、左室收缩末期内径（LVDs）及左室射血分数（LVEF）等，并根据术前超声心动图指标对疗效进行预测。结果：术后MR程度及左房室大小均较术前显著减小。术前LVEF〈60％的患者术后LVEF明显改善。MR复发者7例（5.8％），LVDd无明显缩小者13例（10．8％），术后LVEF无明显改善者18例（15％）。术前LVEF〈60％、LVDs≥45mm、存在心梗是术后左室功能无改善的危险因素；而存在心梗也是术后LVDd无明显缩小的危险因素。结论：超声心动图可对二尖瓣关闭不全作出精确诊断，对预测MVR疗效有一定的价值。Purposes： To evaluate and predict the outcome of mitral valve repair （MVR） using echocardiography. Materials and Methods： From June 2004 to June 2006, 120 patients （75 males, 45 females, mean age 52 ± 16.7 years） had MVR and echocardiographic follow-up （1 -25.5 months, mean 6.1 ± 5.4 months） . The severity of mitral regurgitation （MR）, the dimensions of LV and LA, and LV ejection fraction （LVEF） were assessed and compared using pre- and post-operative echocardiography. The prediction value of the preopera- tive echocardiographic parameters was analyzed. Results： The severity of mitral regurgitation （ MR）, the dimensions of heart chambers were significantly reduced and LVEF improved after MVR. In follow up, recurrent MR was found in 7 （5.8%）, enlarged LV in 13 （ 10.8% ）, and persistence of low LVEF in 18 （ 15% ） patients. Multivariable analysis found that preoperative LVEF 〈 60%, LVDs ≥45mm and a positive MI history were independent predictors for poorer LVEF after MVR; A MI history was also a risk factor for absence of LVDs reduction. Conclusion： Echocardiography could accurately diagnose MR and might predict outcome of MVR.

关 键 词：二尖瓣修复 二尖瓣关闭不全 超声心动图 

分 类 号：R540.45[医药卫生—心血管疾病]