主动脉瓣脱垂患者临床特征及心脏超声表现  

Clinical characteristics and echocardiography findings in patients with aortic valve prolapsed

作　　者：于宏 赵艳辉 Yu Hong, Zhao Yanhui.(Department of Ultrasound, Affiliated Hospital of Chifeng University, Chifeng 024000, China)

机构地区：[1]赤峰学院附属医院超声科,赤峰024000

出　　处：《中国循证心血管医学杂志》2018年第5期604-606,610,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的分析主动脉瓣脱垂患者的临床特征及心脏超声表现。方法入组2013年5月20日~2017年9月30日于赤峰学院附属医院门诊就诊的主动脉瓣脱垂患者112例,总结患者病因及一般情况,并行心脏超声检查,评估主动脉窦部(Ao)、升主动脉内径(AAo)、左房前后径(LA)、左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)、左室射血分数(LVEF)及瓣膜返流情况。结果 112例患者平均年龄(48.83±13.73)岁,男性比82.1%;以主动脉瓣二叶畸形最为多见,共28例(25%),感染性心内膜炎16例(14%),主动脉瓣二叶畸形合并感染性心内膜炎7例(6%),主动脉瓣退行性变7例(6%),室间隔缺损5例(4%),马凡综合征3例(3%),主动脉夹层2例(2%),主动脉窦瘤4例(4%),白塞病3例(3%)。心脏超声结果:左室增大,平均LVEDD(65.68±10.03)mm,LVESD(45.73±10.32)mm,LVEF(56.70±9.63)%,常伴有主动脉瓣大量返流(91.7%),主动脉窦部平均内径(37.36±7.88)mm,升主动脉平均内径(38.67±6.85)mm,合并中-重度肺动脉高压的比例是8.1%。对于主动脉瓣为三叶的患者,最常见的脱垂的瓣叶为右冠瓣(45.5%),对于主动脉瓣二叶畸形的患者,左前瓣脱垂的比例较大,为15.2%。结论主动脉瓣脱垂常见的原因是主动脉瓣二叶畸形和感染性心内膜炎,主动脉瓣叶脱向左室流出道是直接征象,右冠瓣脱垂的比例最高,绝大多数伴有左室明显增大及主动脉瓣大量返流。Objective To analyze the clinical characteristics and echocardiography findings in patients with aortic valve prolapsed. Methods The patients（n=112） were chosen from the Outpatient Department of Affiliated Hospital of Chifeng University from May 20, 2013 to Sept. 30, 2017. The disease cause and general information were summed up in all patients. Echocardiogram was used to review the inner diameters of aortic sinus（Ao） and ascending aorta（AAo）, left atrial anteroposterior diameter（LA）, left ventricular end-diastolic inner diameter（LVEDd）, left ventricular end-systolic diameter（LVESd）, left ventricular ejection fraction（LVEF） and valve regurgitation. Results The average age was（48.83±13.73） and male percentage was 82.1% in 112 patients. The bicuspid aortic valve disease was the most common in all patients [n=28（25%）], and 16（14%） with infective endocarditis（IE）, 7（6%） with bicuspid aortic valve disease complicated by IE, 7（6%） with aortic valve degeneration, 5（4%） with ventricular septal defect（VSD）, 3（3%） with Marfan syndrome, 2（2%） aortic dissection, 4（4%） with aneurysm of sinus of Valsalva（SVA）, and 3（3%） with behcet disease. The results of echocardiogram showed that enlargement of left ventricular, mean LVEDd was（65.68±10.03）, mean LVESd was（45.73±10.32） and LVEF was（56.70±9.63） and percentage of cases complicated by severe valve regurgitation（91.7%）. The inner diameter of Ao was（37.36±7.88） mm and that of AAo was（38.67±6.85） mm and percentage of cases complicated by medium-severe pulmonary arterial hypertension（PAH） was 8.1%. The most common valve prolapsed occurred in right coronary valve（45.5%） in patients with tricuspid aortic valve disease, and left anterior valve prolapsed（15.2%） was common in patients with bicuspid aortic valve disease. Conclusion The causes of aortic valve prolapsed are commonly bicuspid aortic valve disease and IE. The direct sign is prolapsed of aortic valve to lef

关 键 词：主动脉瓣脱垂 感染性心内膜炎 心脏超声 左室舒张末内径 主动脉瓣二叶畸形 

分 类 号：R542.41[医药卫生—心血管疾病]