二尖瓣对合面积的定量研究  

The quantitative experiment research of mitral valve coaptation area

作　　者：李继勇[1] 何怡华[2] 张健群[1] 王琳琳[3] 张亮[4] 

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心外科,北京100029 [2]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所超声诊断科,北京100029 [3]北京大学第一医院超声科 [4]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所麻醉科,北京100029

出　　处：《心肺血管病杂志》2013年第4期512-515,共4页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家自然科学基金(30970840)

摘　　要：目的:采用经食管实时三维超声技术(RT-3D-TEE)通过犬的动物试验来观察左心室压力逐渐增大,二尖瓣出现中度反流的情况下,二尖瓣对合面积以及对合指数的变化趋势。方法:应用飞利浦IE33超声心动图成像仪对15例实验犬行RT-3D-TEE检查,并建立动物实验模型,在逐渐缩窄升主动脉造成左心室压力升高的情况下获取RT-3D-TEE图像,直至二尖瓣出现中度反流为止。结果:15只犬中14只犬实验成功,1只犬在游离升主动脉根部时致升主动脉破裂。所得超声图像质量均达到定量分析要求。舒张期总面积在有无二尖瓣反流的情况下差异无统计学意义(P>0.05)。左心室压力、收缩期总面积、对合面积、对合指数在有无二尖瓣反流的情况下的差异有统计学意义(P<0.01)。舒张期面积与左心室压力变化无相关(r=0.162,P>0.05)。收缩期面积与左心室压力呈正相关(r=0.686,P<0.01)。对合面积与左心室压力呈负相关,(r=-0.497,P<0.01)。对合指数与左心室压力呈负相关(r=-0.798,P<0.01)。结论:二尖瓣出现反流的情况下对合面积和对合指数有明显下降,对合指数可以更精确的反映二尖瓣出现反流的程度,为二尖瓣成形手术预后提供参考。Objective：We observed the diversity tendency of mitral valve coaptation area and coaptation index with left ventricular pressure increased gradually and moderate regurgitation appearanced by experiment of canine with Real-time three-dimensional transesophageal echocardiography（RT-3D-TEE）.Methods：RT-3D-TEE images were obtained by gradual stenosis the ascending aorta of dogs resulting the pressure of left ventricular rising and the moderate regurgitation appearanced.Results：Of the 15 dogs,14 dogs were got successful experiment,one dog died for the rupture of ascending aorta.The images of RT-3D-TEE were clear for quantitative analyze.There was no significant defference of mitral leaflets surface area in early-diastole between the moderate regurgitation group and no regurgitation group（P0.05）.There was significant defference of left ventricular pressure,area of mitral leaflets in late-systolic,coaptation area,coaptation index between two groups（P0.01）.There was no significant correlation between area of mitral leaflets in early-diastolic and left ventricular pressure（r=0.162,P0.05）.There was significant positive correlation between area of mitral leaflets in late-systolic and left ventricular pressure（r=0.686,P0.01）.There was significant negative correlation between coaptation area and left ventricular pressure（r=-0.497,P0.01）.There was significant negative correlation between coaptation index and left ventricular pressure（r=-0.798,P0.01）.Conclusion：Coaptation area and coaptation index had a significant decrease with mitral valve regurgitation.Coaptation index reflect the tendency of mitral valve regurgitation more precisely,providing information of follow-up after mitral valve repair.

关 键 词：对合面积 对合指数 二尖瓣反流 

分 类 号：R54[医药卫生—心血管疾病]