经食管实时三维超声研究不同反流程度二尖瓣脱垂患者瓣环动态变化  

Quantitative Assessment of Mitral Annulus Dynamic in Mitral Valve Prolapse with Varying Degree Mitral Regurgitation Using Real-Time Three-Dimensional Transesophageal Echocardiography

作　　者：崔翼靖[1] 陈昕[1] 张慧慧[1] 周文艳[1] 杨军[1] 

机构地区：[1]中国医科大学附属第一医院心血管超声科,沈阳市110001

出　　处：《中国超声医学杂志》2017年第4期313-315,共3页Chinese Journal of Ultrasound in Medicine

基　　金：沈阳市科技计划项目基金(No.F15-199-1-32)

摘　　要：目的应用经食管实时三维超声心动图(RT-3DTEE)分析二尖瓣脱垂(MVP)患者不同程度反流瓣环立体结构在全心动周期的变化规律。方法57例行RT-3DTEE检查的患者,对照组33例,MVP患者24例,其中14例为二尖瓣中-重度反流组,10例为二尖瓣轻度反流组。应用QLab 7.0软件分别于舒张早、中、晚期和收缩早、中、晚期测量二尖瓣瓣环。结果与对照组相比,轻度MR组DAP于收缩中晚期、舒张早期、舒张晚期增大(P<0.05);中-重度MR组于全心动周期瓣环C3D、A2D、DAP、DAlPm均明显增大(P<0.05)。与轻度MR组相比,中-重度MR组DAP于全心动周期均明显增大,A2D、C3D、DAlPm于收缩晚期、舒张中期增大(P<0.05),而H、H/DAlPm差异均无统计学意义(P>0.05)。结论不同程度MR瓣环结构变化不同,瓣环前后径扩大比前外后内径出现较早。Objective To analyze the mitral annulus geometry and dynamic over the cardiac cycle in mitral valve prolapse （MVP） with varying degree mitral regurgitation using real-time three-dimensional transesophageal echocardiography （RT-3DTEE）. Methods RT-3DTEE of the mitral valve was acquired in 57 subjects, including 33 normal subjects, 24 patients with MVP. MVP group was divided into two subgroups, 14 patients with moderate to severe regurgitation, 10 patients with mild MR. Mitral annular measurements were performed during the cardiac cycle in early, middle, late diastole and early, middle, late systole using Mitral-Valve-Quantification Software. Results Compared with control group, DAP was significantly increased at middle systole, late systole and early diastole, in mild MR group（P〈0.05）. Compared with control group, C3D, A2D, DAP and DA1Pm was significantly increased and 0 was significantly decreased throughout the cardiac cycle in moderate to severe MR group （P^0.05）. Compared with mild MR group, DAP increased significantly throughout the cardiac cycle in moderate to severe MR group. A2D, C3D and DAtPm increased significantly at LS and MD in moderate to severe MR group（P〈0.05）. H and H/DA1Pm has no significant difference in moderate to severe MR group （P〈0.05）. Conclusions Different degree of mitral regurgitation has different changes on mitral annulus and the dilatation of DAP occurred earlier than DAIPm.

关 键 词：超声心动图 三维 经食管 二尖瓣脱垂 二尖瓣瓣环 

分 类 号：R540.45[医药卫生—心血管疾病]