老年患者二尖瓣腱索断裂的临床和超声特征  

The clinical and echocardiographic features of ruptured mitral chordae tendineae in elderly patients

作　　者：王秋霜[1] 罗北捷[1] 黄党生[1] 沈东[1] 张许文[1] 张春红[1] 张丽伟[1] 白静[1] 孟娟娟[1] 

机构地区：[1]解放军总医院第一附属医院心内科,北京100037

出　　处：《医学影像学杂志》2008年第8期861-863,共3页Journal of Medical Imaging

摘　　要：目的:探讨老年患者二尖瓣腱索断裂的临床特点及超声特征。方法:对22例老年二尖瓣腱索断裂患者的临床及超声资料进行总结分析,并与12例非老年二尖瓣腱索断裂患者进行对比。结果:老年组非风湿性二尖瓣病变21例(93.5%),其中合并高血压18例(81.8%),合并冠心病13例(59.1%),而非老年组风湿性二尖瓣病变6例(50.0%),非风湿性二尖瓣病变6例(50.0%),两组患者基础疾病的构成有显著差异(P<0.05);老年组发生急性左心衰16例(72.7%),明显高于非老年组(P<0.05);超声心动图检查老年组10例(45.5%)发生全心扩大,12例(54.5%)出现肺动脉高压,均高于非老年组(P<0.05)。结论:老年二尖瓣腱索断裂患者容易出现全心扩大,肺动脉高压,其主要原因可能与合并有高血压、冠心病有一定的关系。Objective：This study was sought to evaluate the clinical and echocardiographic （ECHO） features of ruptured mitral chordare tendineae （RMCT） in elderly patients. Methods： The clinical and ECHO data of 22 elderly patients with RMCT identified by transesophageal echocardiography were studied and compared with those of 12 younger adult patients with RMCT. Results： In elderly group 21 （93.5%） eases were non-rheumatie RMCT, and 18（81.8%） eases had the histories of hypertension, 13（59.1%） eases were with coronary heart disease. In younger group 6（50.0%） eases were rheumatic RMCT, the other 6（50.0%） cases were non-rheumatic RMCT. The antecedent heart disease of the 2 groups were different （ P 〈0.05）. In elderly group there were, 16（72.7% ） eases with repeatly heart failure, which were higher than those in younger group. Comparing the results of echocardiography, we found that both left and right ventricles were enlarged in 10（45.5% ） eases in elderly group, only 3（25% ） cases in younger group; and 12（54.5% ） eases were with pulmonary hypertension in edler group, 3（25% ） eases were in younger group. The differences between 2 groups were significandy （ P 〈0.05）. Conclusion：The elderly patients with RMCT are more easily to get pulmonary hypertension and whole heart enlarged. The combination of coronary heart disease, hypertension might be the possible reasons.

关 键 词：超声心动图 二尖瓣 腱索断裂 

分 类 号：R541[医药卫生—心血管疾病] R445.1[医药卫生—内科学]