二尖瓣舒张期反流超声心动图表现及临床意义  

Echocardiography Characteristics and Clinical Significance in Patients With Diastolic Mitral Regurgitation

作　　者：王翠华[1] 黄云洲[1] 张亚东[1] 郭轩[1] 刘爽[1] 邵洋[1] 沈胜男[1] 

机构地区：[1]泰达国际心血管病医院超声科,天津市300457

出　　处：《中国循环杂志》2016年第5期477-479,共3页Chinese Circulation Journal

摘　　要：目的:探讨二尖瓣舒张期反流超声心动图表现及临床意义。方法:收集我院15例二尖瓣舒张期反流患者,其中主动脉瓣大量反流1例,心房颤动(房颤)6例,心房扑动(房扑)2例,Ⅱ°Ⅰ型房室传导阻滞1例,Ⅱ°Ⅱ型房室传导阻滞1例,Ⅲ°房室传导阻滞4例,观察二尖瓣反流特点并测量心室率、左心大小及左心功能。结果:1例主动脉瓣大量反流患者二尖瓣舒张期反流发生于减慢充盈期,反流量少、低于正向血流速度,6例房颤患者发生于舒张中晚期,反流量少、明显低于正向血流速度,余8例均发生于舒张中晚期,流速达到或超过正向血流速度。15例均有心室率缓慢,左心增大,左心室射血分数(LVEF)偏低,组织多普勒成像(TDI)显示二尖瓣环舒张早期峰值减低。93%(14/15)的患者有明显收缩期反流。结论:二尖瓣舒张期反流时相、反流量、反流速度各有特点,大多伴有收缩期反流,均合并心脏结构及功能异常改变,超声心动图检查为临床治疗时机提供重要信息。Objective： To investigate echocardiography characteristics and clinical significance in patients with diastolic mitral regurgitation.Methods： A total of 15 patients with diastolic mitral regurgitation were studied including 1 patient with large volume of aortic regurgitation, 6 with atrial fibrillation（AF）, 2 with atrial flutter, 1 with Ⅱ° type I atrio-ventricular block（A-V block）, 1 with Ⅱ° type Ⅱ A-V block and 4 with Ⅲ° A-V block. The characteristics of mitral regurgitation were observed, the heart rates, left ventricular size were measured and left ventricular function was detected in all patients.Results： There was 1 large volume aortic regurgitation patient with diastolic mitral regurgitation occurred in slow filling phase with less volume, it was less than positive velocity; 1 AF patient occurred in mid and late diastolic phase with less volume, it was obviously less than positive velocity; the rest 8 patients all occurred in mid and late diastolic phase, the velocity reached or surpassed to positive velocity. All 15 patients had slow heart rate, increased left heart, decreased left ventricular ejection fraction, tissue Doppler imaging showed that the early diastolic peak slowed down in mitral ring. There were 93%（14/15） patients having obvious systolic regurgitation.Conclusion： The time phase, quantity and velocity of diastolic mitral regurgitation have various characteristics, most of them associated with systolic regurgitation combining abnormal cardiac structure and function. Echocardiography provides important information for clinical treatment.

关 键 词：超声心动描记术 二尖瓣闭锁不全 

分 类 号：R54[医药卫生—心血管疾病]