急性风湿性心脏炎致瓣膜脱垂的超声心动图分析  

Echocardiographic Analysis of Valvular Prolapse Produced by Acute Rheumatic Carditis

作　　者：林红[1] 陆堃[1] 周令仪[1] 

机构地区：[1]中山医科大学附属第一医院超声心动图室,广东广州510080

出　　处：《中山医科大学学报》2000年第5期384-386,共3页Academic Journal of Sun Yat-sen University of Medical Sciences

基　　金：中山医科大学附属第一医院科研基金!资助课题 (1993 -34)

摘　　要：【目的】探讨急性风湿性心脏炎与瓣膜脱垂的相关性。【方法】用超声心动图检查 110例根据修订Jones标准(1982 )确诊为风湿热并有急性风湿性心脏炎的患者发生瓣膜脱垂的情况。【结果】超声心动图发现二尖瓣脱垂 77例 (70 % ) ,其中前叶脱垂 5 8例 (5 3% ) ,后叶脱垂 13例 (12 % ) ,前后叶均脱垂 6例 (5 % ) ;主动脉瓣脱垂 2 3例 (2 1% ) ,其中 4例不伴二尖瓣脱垂。总的瓣膜脱垂发生率为 74% (81/110 ) ,与对照组病毒性心肌炎 6 % (10 /15 4)比较有明显的差异 (P <0 0 1)。【结论】急性风湿性心脏炎是我国瓣膜脱垂 ,尤其是二尖瓣前叶脱垂的重要原因。Objective To evalute the relation between acute rheumatic carditis and valve prolapse. Methods 110 cases of rheumatic fever associated with acute rheumatic carditis diagnosed on the basis of the revised Jones′ criteria (1982)wereassessedbyechocardiography. Results Echocardiographyrevealedmitral valve prolapse in 77/110(70%) cases, including 58/110(53%) with anterior mitral leaflet, 13/110(12%) with posterior mitral leaflet, and 6/110(5%) with combined anterior and posterior mitral leaflet prolapse. Aortic valve prolapse was observed in 23/110(21%) cases. All cases of aortic valve prolapse were combined with mitral valve prolapse except 4 cases. The incidences of valve prolapse for acute rheumatic carditis and the control group for viral myocarditis were 74% (81/110) and 6% (10/154), respectively. And there was a significant difference between them (P<0 01). Conclusions It suggests that in China, acute rheumatic carditis is an important etiology of valve prolapse, especially for anterior mitral leaflet prolapse.

关 键 词：急性风湿性心脏炎 瓣膜脱垂 超声心动图 

分 类 号：R542.5[医药卫生—心血管疾病] R540.45[医药卫生—内科学]