主动脉瓣退行性变的超声观察及血流动力学分析  

Degenerative Aortic Valvular Disease Observed with Echocardiography and Analyzed through Hemodynamics

作　　者：郭宝生[1] 杨军[1] 姜克新[1] 栾朝霞[1] 喻晓娜[1] 李颖[1] 刘守君[1] 

机构地区：[1]中国医科大学附属盛京医院超声科,沈阳市110004

出　　处：《中国超声医学杂志》2010年第1期45-47,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的用超声观察主动脉瓣退行性变钙化斑块形态学的特点,并分析其形成的解剖学及血流动力学基础。方法 427例发生主动脉瓣退行性变并钙化斑块形成的患者为研究对象,根据钙化斑块所处主动脉瓣的位置将其分为突向瓣窦型、均衡型及突向瓣口型,并分析各型间的发生率是否存在统计学差别。结果 427例主动脉瓣退行性变并钙化斑块形成的患者病变瓣膜469个,其中突向瓣窦型病变瓣膜293个,高于均衡型(P<0.01)及突向瓣口型(P<0.01);均衡型病变瓣膜105个,高于突向瓣口型(P<0.05);突向瓣口型病变瓣膜71个。突向瓣口型主动脉瓣反流发生率高于突向瓣窦型及均衡型(均P<0.01)。结论主动脉瓣退行性变钙化斑块多突向瓣窦侧与该处血流剪切力小,容易使钙质沉着有关;而收缩期瓣口侧承受较大的剪切力,不易使钙质沉着。Objective To analyze the prerequisite in anatomy and hemodynamics of the formation of degenerative aortic valvular disease （DAVS） by observing the morphological characteristic of the calcification plaque （CP） of DAVS with echocardiography. Methods 427 patients with CP of DAVS were recruited as the subjects and were divided into 3 types according to the location of CP in aortic valve which were protruding valvular sinus （CPS）, equivalence （CPE） and protruding valvular orifice （CPO）, and whether there was statistical difference in incidence among the 3 types or not was analyzed. Results There were 469 aortic valves with CP in 427 patients of DAVS among which there were 293 valves in CPS, which was higher than that in CPE （105 valves, P〈0.01） and CPO （71 valves, P〈0.01）. The incidence of aortic valvular regurgitation was higher in CPO than that in CPS and CPE （both P 〈 0.01）. Conclusions Most of CP in DAVS protrudes into the aortic valvular sinus due to its minor flow shear stress and susceptibleness to calcinosis, while the side of aortic valvular orifice bears great flow shear stress and therefore is insusceptible to calcinosis.

关 键 词：主动脉瓣退行性变 钙化斑块 剪切力 

分 类 号：R542.5[医药卫生—心血管疾病] R445.1[医药卫生—内科学]